Summary
The effect of continuous positive pressure ventilation was studied in 23 dogs in whom pulmonary oedema was induced by rapid intravenous infusion of dextran 40. CPPV slowed but did not prevent the formation of oedema.
CPPV prevented or reversed the formation of liver-like areas in the dependent lobes, maintaining the oedematous lung compliant and aerated. This led to a reduction of shunt and an increase in PaO 2. The use of CPPV decreased cardiac output and body oxygen consumption. Mixed venous oxygen tension was higher in dogs ventilated by CPPV and these dogs tolerated fulminant frothy oedema without distress.
Résumé
Ce travail avait pour but d’étudier les effets d’une ventilation à pression positive constante chez 23 chiens en œdème pulmonaire (causé par l’infusion rapide de Dextran 40). La pression positive continuelle a ralenti mais n’a pas empêché la formation d’œdème.
Elle a aussi empêché ou rendu réversible la formation de zones hépatisées dans les lobes déclives du poumon, tout en le maintenant compliant et aéré. Conséquemment, on a assisté à une diminution du shunt et une augmentation de la PaO 2. La pression positive constante a diminué le débit cardiaque et la consommation d’oxygène. La pression partielle de l’oxygène dans le sang veineux mixte était plus élevée chez les chiens ventilés sous PEEP et ces chiens supportaient sans trop de détresse un œdème pulmonaire suraigu.
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Obdrzalek, J., Kay, J.C. & Noble, W.H. The effects of continuous positive pressure ventilation on pulmonary oedema, gas exchange and lung mechanics. Canad. Anaesth. Soc. J. 22, 399–409 (1975). https://doi.org/10.1007/BF03004854
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DOI: https://doi.org/10.1007/BF03004854