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Effect of positive end-expiratory pressure ventidation on organ blood volumes

Research Project

Project/Area Number 04454397
Research Category

Grant-in-Aid for General Scientific Research (B)

Allocation TypeSingle-year Grants
Research Field 麻酔学
Research InstitutionKawasaki Medical School

Principal Investigator

TAKAORI Masuhiko  Kawasaki Medical School Department of Anesthesiology, Professor, 医学部, 教授 (30068978)

Co-Investigator(Kenkyū-buntansha) KIMURA Kenichi  Kawasaki Medical School Department of Anesthesiology, Research Associate, 医学部, 助手 (90214874)
FUKUI Akira  Kawasaki Medical School Department of Anesthesiology, Assistant Professor, 医学部, 講師 (50189924)
FUJITA Yoshihisa  Kawasaki Medical School Department of Anesthesiology, Associate Professor, 医学部, 助教授 (10144263)
Project Period (FY) 1992 – 1994
Project Status Completed (Fiscal Year 1994)
Budget Amount *help
¥5,400,000 (Direct Cost: ¥5,400,000)
Fiscal Year 1994: ¥700,000 (Direct Cost: ¥700,000)
Fiscal Year 1993: ¥2,000,000 (Direct Cost: ¥2,000,000)
Fiscal Year 1992: ¥2,700,000 (Direct Cost: ¥2,700,000)
Keywordspositive end-expiratory pressure ventilation / organ blood volume / distribution of circulating blood / cardiac output / isotope labelled red cells / intraabdominal pressure / vasoactive drug / 循環血液量 / 胸腔内圧 / 呼気終末陽圧呼吸 / 赤血球分布 / 連続的血液量測定
Research Abstract

At initiation of positive end-expiratory pressure ventilation (PEEP), some decreases in cardiac out are usually observed in practice. However its mechanism remains still obscure. A hypothesis, that the PEEP may move the circulating blood from the central area, such as the heart and lung, to peripheral vessels and thus the PEEP may decrease the venous return, has been supported mostly consistently. We intended to confirm this hypothesis in this study and to find the peripheral area where the blood pooling would occur most intensively. Further we attempted to observe how long the pooling would be continued after the PEEP and to adopt how we could prevent the pooling.
Experiments were carried out in beagles which were anesthetized with ketamine-N_2O-O_2 and fully paralyzed with vecuronium. Tow mililiters of autologous packed red cells which were labelled with ^<99m>Tc (2 mCi) were injected intravenously and density of the red cells was determined in the brain, thoracic organs (mainly the h … More eart and lungs), liver, splen, adductor muscles in the hind limb and one of the femoral vein with the fixed lumen by gamma ray detectors, respectively, and then blood volumes were calculated with the counted radioactivities and hematocrit value for the blood in the organ.
While zero, 5,10,15, and 20 cmH_2O PEEP were loaded randomly, decreases in the circulating blood volume and thoracic organ blood volume were observed inversely with the changes in PEEP.On the hand, the blood volumes in the liver, spleen and skeletal muscle increased paralleling with the changes in PEEP.Cardiac output measured with thermodilution technique decreased paralleling with the changes in PEEP.
In the second experimented series, the lower part of abdomen was compressed by an air tourniquet and the intraabdominal pressure was elevated to 10 and 20 cmH_2O randomly for each PEEP.By this procedure, all changes in the organ blood volume described above were attenuated and, particularly, both decrease in the circulating blood volume and increase in the skeletal muscle blood volume disappeared. However the decrease in cardiac output had still persisted.
In the third series, effects of dopamine (5 mug, kg^<-1>, min^<-1>) or isosorbid dinitrate (2 mug, kg^<-1>, min^<-1>) on the changes in organ blood volume and cardiac output were observed under 15 cmH_2O PEEP with or without 20 cmH_2O intraabdominal pressure. None of definite change was noted in the organ blood volumes either with the infusion of dopamine or isosorbide dinitrate. However the decrease in cardiac output recovered during the infusion of dopamine but not isosorbide dinitrate.
From the results obtained above, we presumed that the decrease in cardiac output under PEEP is caused by not sole factor but by complexes of many factors. In the future it seems to need more substantial study, particularly with endocrinological approch. Less

Report

(4 results)
  • 1994 Annual Research Report   Final Research Report Summary
  • 1993 Annual Research Report
  • 1992 Annual Research Report
  • Research Products

    (12 results)

All Other

All Publications (12 results)

  • [Publications] 福井 明,高折益彦,木村健一,藤田善久: "終末呼気陽圧(PEEP)人工呼吸の臓器血液量に及ぼす影響" 循環制御. 14. 537-543 (1993)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] 福井 明,高折益彦,木村健一,藤田善久: "終末呼気陽圧呼吸の臓器血液量に及ぼす影響-腹腔内圧の影響" 循環制御. 15. 249-257 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] 福井 明,高折益彦,木村健一,藤田善久: "終末呼気陽圧人工呼吸の臓器血液量に及ぼす影響-腹腔内圧と血管作動薬の影響" 循環制御. 15(掲載許可済). (1995)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Takaori,M.,Fukui,A.,Kimura,K.,Fujita,Y.: "The effect of positive end-expiratory pressure on the cardiac output and organ blood volumes accompanied with increases in intraabdominal pressure." Proc.9th.Asian-Australasian Congress of Anaesthesists. 9:Suppl.2. 194 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Takaori,M.,Fukui,A.,Kimura,K.,Fujita,Y.: "The effect of positive end-expiratory pressure on the cardiac output and organ blood volumes accompanied with increases in intraabdominal pressure." Pathophysiology. 2:Suppl.1. 356 (1994)

    • Description
      「研究成果報告書概要(和文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Fukui, A., Takaori, M., KimuRA,K., Fujita, Y.: "Effect of positive end-expiratory positive pressure vintilation on organ blood volumes" Circulation Control. 14 (4). 537-543 (1993)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Fukui, A., Takaori, M., Kimure, K., Fujita, Y.: "Effect of positive end-expiratory positive pressure ventilation on organ organ blood volumes -Effect of increased intraabdominal pressure" Circuration Control. 15 (2). 249-257 (1994)

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] Fukui, A., Takaori, M., Kimure, K., Fujita, Y.: "Effect of positive end-expiratory positive pressure ventilation on organ blood volumes -Effects of vasoactive drugs under increased intraabdominal pressure" Circuration control 15 (5) : , accepted to be published in 1995. (March).

    • Description
      「研究成果報告書概要(欧文)」より
    • Related Report
      1994 Final Research Report Summary
  • [Publications] 福井 明、高折 益彦、木村 健一、藤田 喜久: "終末呼気陽圧呼吸の臓器血液量に及ぼす影響-腹腔内圧と血管作動薬の影響" 循環制御. 15. 掲載許可済 (1995)

    • Related Report
      1994 Annual Research Report
  • [Publications] Takaori,M.,Fukui,A.,Kimura,K.,Fujita,Y.: "The effect of positive end-expiratory pressure on the cardiac output and organ blood volumes accompanied with increases in intraabdominal pressure" Proc.9th.Asian-Australasian Congress of Anaesthetists. 9:Suppl.2. 194 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] Takaori,M.,Fukui,A.Kimura,K.,Fujita,Y.: "The effect of positive end-expiratory pressure on the cardiac output and organ blood volumes accompanied with increases in intraabdominal pressure" Pathophysiology. 2:Suppl.1. 356 (1994)

    • Related Report
      1994 Annual Research Report
  • [Publications] 福井 明、高折益彦,木村健一、藤田喜久: "終末呼気陽圧呼吸の臓器血液量におよぼす影響-腹腔内圧の影響" 循環制御. 15,2号. (1994)

    • Related Report
      1993 Annual Research Report

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Published: 1992-04-01   Modified: 2016-04-21  

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