Hemodynamic effects of continuous negative extrathoracic pressure and continuous positive airway pressure in piglets with normal lungs

J. A. Adams, H. Osiovich, R. N. Goldberg, C. Suguihara, Eduardo Bancalari

Research output: Contribution to journalArticle

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Abstract

The hemodynamic effects produced by continuous positive airway pressure (CPAP) and continuous negative extrathoracic pressure (CNEP) of 4 and 8 cm H2O were compared in 8 normal, spontaneously breathing piglets. Arterial blood gases and hemodynamic measurements were obtained before and during CPAP and CNEP of 4 and 8 cm H2O. CPAP 8 cm H2O and CNEP 8 cm H2O produced significant increases (p < 0.01) in PaO2 from baselines 76 ± 3 to 85 ± 3 and 77 ± 4 to 85 ± 3 mmHg,respectively. No significant changes occurred in PaCo2 or cardiac index, except during CPAP 8 cm H2O [38 ± 1 to 44 ± 2 mmHg (p < 0.05) and 376 ± 30 to 330 ± 30 ml/kg/min (p < 0.05), respectively]. During CPAP of 4 cm H2O, significant increases occurred in mean right atrial pressure (P̄ra) (2.1 ± 0.3 to 3.3 ± 0.4 mmHg; p < 0.01), left ventricular end-diastolic pressure (LVEDP) (2.8 ± 0.4 to 3.7 ± 0.3 mmHg; p < 0.01), and mean pulmonary artery pressure (P̄pa) (12.9 ± 0.8 to 15.1 ± 0.8 mmHg; p < 0.01). CPAP of 8 cm H2O produced marked increases in P̄ra (2.1 ± 0.2 to 4.9 ± 0.7 mmHg: p < 0.01), LVEDP (2.7 ± 0.5 to 4.5 ± 0.4 mmHg; p < 0.01) and P̄pa (12.8 ± 0.8 to 17.7 ± 0.6 mmHg, p < 0.01). In contrast, CNEP of 8 cm H2O produced decreases in P̄ra (2.1 ± 0.2 to 1.3 ± 0.3 mmHgHg; p < 0.01), LVEDP (2.6 ± 0.5 to 1.7 ± 0.4mmHg; p < 0.01), and P̄pa (12.9 ± 1.0 to 11.4 ± 1.0 mmHg; p < 0.01). CNEP in contrast to CPAP produced an improvement in oxygenation while decreasing vascular pressures and maintaining cardiac output near basal levels. These data support clinical experience which suggests a beneficial effect of CNEP in the treatment of patients with increased pulmonary vascular resistance and pulmonary hypertension.

Original languageEnglish
Pages (from-to)69-75
Number of pages7
JournalBiology of the Neonate
Volume62
Issue number2-3
StatePublished - Jan 1 1992

Fingerprint

Continuous Positive Airway Pressure
Hemodynamics
Pressure
Lung
Blood Pressure
Atrial Pressure
Pulmonary Hypertension
Cardiac Output
Vascular Resistance
Pulmonary Artery
Blood Vessels
Respiration
Gases

Keywords

  • Assisted ventilation
  • Continuous negative extrathoracic pressure
  • Continuous positive airway pressure
  • Hemodynamic
  • Neonatal

ASJC Scopus subject areas

  • Developmental Biology
  • Pediatrics, Perinatology, and Child Health

Cite this

Hemodynamic effects of continuous negative extrathoracic pressure and continuous positive airway pressure in piglets with normal lungs. / Adams, J. A.; Osiovich, H.; Goldberg, R. N.; Suguihara, C.; Bancalari, Eduardo.

In: Biology of the Neonate, Vol. 62, No. 2-3, 01.01.1992, p. 69-75.

Research output: Contribution to journalArticle

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AU - Osiovich, H.

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AU - Bancalari, Eduardo

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N2 - The hemodynamic effects produced by continuous positive airway pressure (CPAP) and continuous negative extrathoracic pressure (CNEP) of 4 and 8 cm H2O were compared in 8 normal, spontaneously breathing piglets. Arterial blood gases and hemodynamic measurements were obtained before and during CPAP and CNEP of 4 and 8 cm H2O. CPAP 8 cm H2O and CNEP 8 cm H2O produced significant increases (p < 0.01) in PaO2 from baselines 76 ± 3 to 85 ± 3 and 77 ± 4 to 85 ± 3 mmHg,respectively. No significant changes occurred in PaCo2 or cardiac index, except during CPAP 8 cm H2O [38 ± 1 to 44 ± 2 mmHg (p < 0.05) and 376 ± 30 to 330 ± 30 ml/kg/min (p < 0.05), respectively]. During CPAP of 4 cm H2O, significant increases occurred in mean right atrial pressure (P̄ra) (2.1 ± 0.3 to 3.3 ± 0.4 mmHg; p < 0.01), left ventricular end-diastolic pressure (LVEDP) (2.8 ± 0.4 to 3.7 ± 0.3 mmHg; p < 0.01), and mean pulmonary artery pressure (P̄pa) (12.9 ± 0.8 to 15.1 ± 0.8 mmHg; p < 0.01). CPAP of 8 cm H2O produced marked increases in P̄ra (2.1 ± 0.2 to 4.9 ± 0.7 mmHg: p < 0.01), LVEDP (2.7 ± 0.5 to 4.5 ± 0.4 mmHg; p < 0.01) and P̄pa (12.8 ± 0.8 to 17.7 ± 0.6 mmHg, p < 0.01). In contrast, CNEP of 8 cm H2O produced decreases in P̄ra (2.1 ± 0.2 to 1.3 ± 0.3 mmHgHg; p < 0.01), LVEDP (2.6 ± 0.5 to 1.7 ± 0.4mmHg; p < 0.01), and P̄pa (12.9 ± 1.0 to 11.4 ± 1.0 mmHg; p < 0.01). CNEP in contrast to CPAP produced an improvement in oxygenation while decreasing vascular pressures and maintaining cardiac output near basal levels. These data support clinical experience which suggests a beneficial effect of CNEP in the treatment of patients with increased pulmonary vascular resistance and pulmonary hypertension.

AB - The hemodynamic effects produced by continuous positive airway pressure (CPAP) and continuous negative extrathoracic pressure (CNEP) of 4 and 8 cm H2O were compared in 8 normal, spontaneously breathing piglets. Arterial blood gases and hemodynamic measurements were obtained before and during CPAP and CNEP of 4 and 8 cm H2O. CPAP 8 cm H2O and CNEP 8 cm H2O produced significant increases (p < 0.01) in PaO2 from baselines 76 ± 3 to 85 ± 3 and 77 ± 4 to 85 ± 3 mmHg,respectively. No significant changes occurred in PaCo2 or cardiac index, except during CPAP 8 cm H2O [38 ± 1 to 44 ± 2 mmHg (p < 0.05) and 376 ± 30 to 330 ± 30 ml/kg/min (p < 0.05), respectively]. During CPAP of 4 cm H2O, significant increases occurred in mean right atrial pressure (P̄ra) (2.1 ± 0.3 to 3.3 ± 0.4 mmHg; p < 0.01), left ventricular end-diastolic pressure (LVEDP) (2.8 ± 0.4 to 3.7 ± 0.3 mmHg; p < 0.01), and mean pulmonary artery pressure (P̄pa) (12.9 ± 0.8 to 15.1 ± 0.8 mmHg; p < 0.01). CPAP of 8 cm H2O produced marked increases in P̄ra (2.1 ± 0.2 to 4.9 ± 0.7 mmHg: p < 0.01), LVEDP (2.7 ± 0.5 to 4.5 ± 0.4 mmHg; p < 0.01) and P̄pa (12.8 ± 0.8 to 17.7 ± 0.6 mmHg, p < 0.01). In contrast, CNEP of 8 cm H2O produced decreases in P̄ra (2.1 ± 0.2 to 1.3 ± 0.3 mmHgHg; p < 0.01), LVEDP (2.6 ± 0.5 to 1.7 ± 0.4mmHg; p < 0.01), and P̄pa (12.9 ± 1.0 to 11.4 ± 1.0 mmHg; p < 0.01). CNEP in contrast to CPAP produced an improvement in oxygenation while decreasing vascular pressures and maintaining cardiac output near basal levels. These data support clinical experience which suggests a beneficial effect of CNEP in the treatment of patients with increased pulmonary vascular resistance and pulmonary hypertension.

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