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Influence of Positive End-Expiratory Pressure Ventilation on Survival During Severe Hemorrhagic Shock

Although a moderate positive end-expiratory pressure (PEEP) level is widely recommended, it is unknown whether moderate PEEP during mechanical ventilation has adverse effects during severe hemorrhagic shock. Therefore, the purpose of our study was to evaluate the effects of 0 cm H 2O PEEP versus 5 c...

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Bibliographic Details
Published in:Annals of emergency medicine 2005-10, Vol.46 (4), p.337-342
Main Authors: Krismer, Anette C., Wenzel, Volker, Lindner, Karl H., Haslinger, Christopher W., Oroszy, Stephan, Stadlbauer, Karl H., Königsrainer, Alfred, Boville, Brian, Hörmann, Christoph
Format: Article
Language:English
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Summary:Although a moderate positive end-expiratory pressure (PEEP) level is widely recommended, it is unknown whether moderate PEEP during mechanical ventilation has adverse effects during severe hemorrhagic shock. Therefore, the purpose of our study was to evaluate the effects of 0 cm H 2O PEEP versus 5 cm H 2O PEEP versus 10 cm H 2O PEEP on short-term survival in a porcine model of severe hemorrhagic shock. Secondary study endpoints were hemodynamic variables and blood gases. Twenty-four anesthetized pigs were bled approximately 45 mL/kg, randomized into 3 groups, and then ventilated with 0, 5, or 10 cm H 2O PEEP. Survival rates were compared using Kaplan-Meier methods with log rank (Mantel Cox) comparison of cumulative survival by treatment group. Seven of 8 0 cm H 2O PEEP animals survived the 120-minute study period, but 8 of 8 5 cm H 2O PEEP animals died within 30 minutes, and 8 of 8 10 cm H 2O PEEP animals were dead within 20 minutes ( P
ISSN:0196-0644
1097-6760
DOI:10.1016/j.annemergmed.2005.02.022