Arterial Pressure Variation during Positive-pressure Ventilation

2005 ◽  
pp. 313-329 ◽  
Author(s):  
A. Perel ◽  
S. Preisman ◽  
H. Berkenstadt
Keyword(s):  
Arterial Pressure ◽  
Positive Pressure Ventilation ◽  
Pressure Variation ◽  
Positive Pressure

Effect of esmolol on positive-pressure ventilation-induced variations of arterial pressure in anaesthetized humans

2004 ◽  
Vol 107 (3) ◽  
pp. 303-308 ◽  
Author(s):  
Hsien Yong LAI ◽  
Cheryl C. H. YANG ◽  
Ching-Feng CHENG ◽  
Fan Yen HUANG ◽  
Yi LEE ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Positive Pressure Ventilation ◽  
Linear Regression Analysis ◽  
Systolic Pressure ◽  
Pressure Variation ◽  
Positive Pressure ◽  
Mechanically Ventilated ◽  
Arterial Pressure Variability ◽  
Before And After ◽  
Sympathetic Regulation

Positive-pressure ventilation-induced variations in arterial pressure have been related to cardiac sympathetic activity in animals. However, the effect of β-adrenoceptor blockade on these variations in anaesthetized humans under positive-pressure ventilation has not yet been investigated. In the present study, RAPV (respiratory-related arterial pressure variability) and %SPV (percentile systolic pressure variation) were determined before and after esmolol treatment in ten mechanically ventilated patients. RAPV and %SPV decreased significantly after intravenous esmolol (1 mg/kg of body weight) treatment (maximal decrease of RAPV, 50% and %SPV, 35%). Linear regression analysis of RAPV and %SPV before and after esmolol treatment both revealed high correlation (r=0.93 and 0.91 respectively). The amplitudes of RAPV and %SPV also significantly increased in a graded way with higher tidal volumes. Thus we propose that esmolol suppresses the variations in arterial pressure induced by positive-pressure mechanical ventilation, and we suggest that RAPV and %SPV may be alternative choices for monitoring cardiac sympathetic regulation in anaesthetized patients under positive-pressure ventilation.

scholarly journals Comparison of Fentanyl-Propofol and Ketamine-Propofol Combination in Induction and Maintenance with Intravenous Anesthesia for Short Surgical Procedures at Moderate Elevations

2021 ◽  
Vol 18 (4) ◽  
pp. 769-775
Author(s):  
Ramesh Bhattarai ◽  
Pawan Kumar Hamal
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Oxygen Saturation ◽  
Surgical Procedures ◽  
Positive Pressure Ventilation ◽  
Study Drug ◽  
Positive Pressure ◽  
Moderate Altitude ◽  
Intravenous Anesthesia

Background: The aim of the study is to evaluate the efficacy of Ketamine-Propofol compared to Fentanyl-Propofol combination during induction and maintenance of total intravenous anesthesia for short surgical procedures at moderate elevation. Methods: A prospective pilot study was done comparing between Fentanyl (1.2 mcg/kg)- Propofol and Ketamine (0.5mg/kg)-Propofol with 30 in each group at moderate altitude of approximately 2514 meters for the requirement of positive pressure ventilation, changes in heart rate and mean arterial pressure intraoperatively, total Propofol consumption and time to attain Modified Steward Score of 6.Results: Requirement for positive pressure ventilation was significantly high in Fentanyl-Propofol group 18 (60%) compared to Ketamine-Propofol 1 (0.03%) [P = 0.00]. Fall in oxygen saturation was significant at 2 minute of Ketamine or Fentanyl [95% CI, 3.10-5.76, P = 0.00], after induction with Propofol [95% CI, 2.30-4.03, P = 0.00], 5 minute [95% CI, 1.66-3.54, P = 0.00], 10 minutes [95% CI, 0.55-2.32, P = 0.02], 15 minutes [95% CI, 0.50-2.09, P = 0.00] and 20 minutes [95% CI, 0.43-2.23, P = 0.00] respectively after study drug between the groups. Total Propofol consumption was significantly higher [95% CI, 0.19-0.43, P = 0.00] in KP (1.55±0.27mg/kg) compared to FP (1.23±0.16 mg/kg). Conclusions: At moderate elevations of 2514 meters, during the induction and maintenance of intravenous anesthesia, Ketamine-Propofol causes significantly less fall in oxygen saturation in the first 20 minutes requiring lesser need of positive pressure ventilation with comparable least fall in heart rate and mean arterial pressure with higher total Propofol consumption when compared to Fentanyl-Propofol. It took a significantly longer time to recovery with Modified steward score of maximum 6 with Ketamine-Propofol.Keywords: Fentanyl; intravenous anesthesia; ketamine; moderate altitude; propofol

Influence of decreased vascular pressures on mechanics of ventilation in dogs

1960 ◽  
Vol 198 (4) ◽  
pp. 873-876 ◽  
Author(s):  
Richard J. Lewin ◽  
Cecil E. Cross ◽  
P. Andre Rieben ◽  
Peter F. Salisbury
Keyword(s):  
Arterial Pressure ◽  
Positive Pressure Ventilation ◽  
Systemic Arterial Pressure ◽  
The Other ◽  
Positive Pressure ◽  
Pulmonary Blood Volume ◽  
Pulmonary Flow ◽  
Open Chest ◽  
Tracheal Pressure ◽  
Blood Pressures

In closed-chest and open-chest dogs the peak insufflation tracheal pressure during constant-volume, positive pressure ventilation increased whenever the systemic arterial pressure was lowered by bleeding. The tracheal pressure was also recorded in open-chest dog experiments, where the pulmonary and the systemic circulations were perfused by separate perfusion systems, the output of which was known. When the blood flow in one circuit was kept constant while the flow in the other was decreased, increases of the tracheal pressure were observed. The effect of systemic hypotension upon tracheal pressure disappeared after cooling or sectioning of the vagi. On the other hand, the effect of decreased pulmonary flow upon tracheal pressure persisted after denervation of the lungs and was observable even in dead dogs. We conclude that a) decrease of the systemic arterial pressure (bleeding) causes reflex increase of the peak insufflation tracheal pressure which is mediated by the vagus nerve. b) decrease of the pulmonary blood pressures and of the pulmonary blood volume below normal cause increased peak insufflation pressures, which are believed to represent decreased pulmonary compliance.

scholarly journals Pulse Pressure Variation Patterns in a Swine Model of Hypovolemia under Spontaneous Breathing vs. Invasive Positive-Pressure Ventilation

2014 ◽  
Vol 1 (6) ◽  
Author(s):  
Mauricio Macário Rocha ◽  
José Marconi Almeida de Souza ◽  
Angelo Amato Vincenzo de Paola ◽  
Antônio Carlos Camargo Carvalho ◽  
Adriano Henrique Pereira Barbosa ◽  
...  
Keyword(s):  
Pulse Pressure ◽  
Pulse Pressure Variation ◽  
Spontaneous Breathing ◽  
Positive Pressure Ventilation ◽  
Pressure Variation ◽  
Positive Pressure ◽  
Swine Model ◽  
Variation Patterns
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