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

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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

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Keywords

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

ASJC Scopus subject areas

  • Developmental Biology
  • Pediatrics, Perinatology, and Child Health

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