the effect of airway pressure release ventilation on pulmonary catheter readings specifically pulmonary capillary wedge pressure in a swine model压力释放通气的影响肺动脉导管读数特别是肺毛细血管楔压在猪模型.pdfVIP

Hindawi Publishing Corporation Anesthesiology Research and Practice Volume 2011, Article ID 371594, 4 pages doi:10.1155/2011/371594 Research Article The Effect of Airway Pressure Release Ventilation on Pulmonary Catheter Readings: Specifically Pulmonary Capillary Wedge Pressure in a Swine Model Ahmad M. Slim, Shaun Martinho, Jennifer Slim, Eddie Davenport, Luadino M. Castillo-Rojas, and Eric A. Shry Cardiology Service, Brooke Army Medical Center, 3851 Roger Brooke Drive, Fort Sam Houston, TX 78234-6200, USA Correspondence should be addressed to Ahmad M. Slim, ahmad.slim@ Received 15 November 2010; Revised 10 January 2011; Accepted 15 January 2011 Academic Editor: Christoph K. Hofer Copyright © 2011 Ahmad M. Slim et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Background. Airway pressure release ventilation (APRV) is a mode of mechanical ventilation that theoretically believed to improve cardiac output by lowering right atrial pressure. However, hemodynamic parameters have never been formally assessed. Methods. Seven healthy swine were intubated and sedated. A baseline assessment of conventional ventilation (assist control) and positive end-expiratory pressure (PEEP) of 5 cm H2 O was initiated. Ventilator mode was changed to APRV with incremental elevations of CPAP-high from 10 to 35 cm H2 O. After a 3-to-5-minute stabilization period, measurements of hemodynamic parameters (PCWP, LAP, and CVP) were recorded at each level of APRV pressure settings. Results. Increasing CPAP caused increased PCWP and LAP measurements above their baseline values. Mean PCWP and LAP were linearly related (LAP =