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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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| Published in: | Annals of emergency medicine 2005-10, Vol.46 (4), p.337-342 |
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| cited_by | cdi_FETCH-LOGICAL-c405t-dfd107602c83a1c7130020c2c15de716d602e720cf2661ecb25bd3ef88bd7e663 |
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| container_end_page | 342 |
| container_issue | 4 |
| container_start_page | 337 |
| container_title | Annals of emergency medicine |
| container_volume | 46 |
| creator | Krismer, Anette C. Wenzel, Volker Lindner, Karl H. Haslinger, Christopher W. Oroszy, Stephan Stadlbauer, Karl H. Königsrainer, Alfred Boville, Brian Hörmann, Christoph |
| description | 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 |
| doi_str_mv | 10.1016/j.annemergmed.2005.02.022 |
| format | article |
| fullrecord | <record><control><sourceid>proquest_cross</sourceid><recordid>TN_cdi_proquest_miscellaneous_68630896</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><els_id>S0196064405002696</els_id><sourcerecordid>68630896</sourcerecordid><originalsourceid>FETCH-LOGICAL-c405t-dfd107602c83a1c7130020c2c15de716d602e720cf2661ecb25bd3ef88bd7e663</originalsourceid><addsrcrecordid>eNqNkVGL1DAQx4Mo3nr6FSQ-6FvXSdom7aOsq3dw4MGqryGbTPeytsmatMX79qbsoj4KfwhkfpMZfiHkDYM1AybeH9faexwwHga0aw5Qr4Hn8CdkxaCVhZACnpIVsFYUIKrqirxI6QgAbcXZc3LFBGtkJeSK4K3v-gm9QRo6eh-SG92MdOttsf11clGPIT7S-4gpTRHpd_Sj6_Xogqc5uynObtY9_ThF5w90hzNm6gaHEOODPjhDdw_B_HhJnnW6T_jqcl6Tb5-2Xzc3xd2Xz7ebD3eFqaAeC9tZBnl1bppSMyNZCcDBcMNqi5IJm0so803HhWBo9rze2xK7ptlbiUKU1-Td-d1TDD8nTKMaXDLY99pjmJISjSihaRewPYMmhpQiduoU3aDjo2KgFsfqqP5xrBbHCngOz72vL0Om_VL703mRmoG3F0Ano_suam9c-stJXvNSQOY2Zw6zktlhVMm45Susi2hGZYP7j3V-A4r9oYI</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>68630896</pqid></control><display><type>article</type><title>Influence of Positive End-Expiratory Pressure Ventilation on Survival During Severe Hemorrhagic Shock</title><source>ScienceDirect Freedom Collection</source><creator>Krismer, Anette C. ; Wenzel, Volker ; Lindner, Karl H. ; Haslinger, Christopher W. ; Oroszy, Stephan ; Stadlbauer, Karl H. ; Königsrainer, Alfred ; Boville, Brian ; Hörmann, Christoph</creator><creatorcontrib>Krismer, Anette C. ; Wenzel, Volker ; Lindner, Karl H. ; Haslinger, Christopher W. ; Oroszy, Stephan ; Stadlbauer, Karl H. ; Königsrainer, Alfred ; Boville, Brian ; Hörmann, Christoph</creatorcontrib><description>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<.0001). Ventilation with 0 cm H
2O PEEP prevented a further reduction of mean arterial blood pressure and cardiac output. When compared with the 0 cm H
2O PEEP group, end-tidal CO
2 declined in the 5 cm H
2O PEEP and 10 cm H
2O PEEP animals. Compared with the 0 cm H
2O PEEP animals, those ventilated with 5 or 10 cm H
2O PEEP had higher lactate levels after 10 minutes.
When compared with pigs ventilated with either 5 or 10 cm H
2O PEEP, those ventilated with 0 cm H
2O PEEP during untreated, severe hemorrhagic shock had significantly improved short-term survival.</description><identifier>ISSN: 0196-0644</identifier><identifier>EISSN: 1097-6760</identifier><identifier>DOI: 10.1016/j.annemergmed.2005.02.022</identifier><identifier>PMID: 16187467</identifier><identifier>CODEN: AEMED3</identifier><language>eng</language><publisher>New York, NY: Mosby, Inc</publisher><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy ; Animals ; Biological and medical sciences ; Blood Gas Analysis ; Disease Models, Animal ; Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care ; Emergency and intensive respiratory care ; Emergency Medicine - methods ; Hemodynamics ; Intensive care medicine ; Medical sciences ; Positive-Pressure Respiration - methods ; Random Allocation ; Shock, Hemorrhagic - blood ; Shock, Hemorrhagic - physiopathology ; Shock, Hemorrhagic - therapy ; Survival Analysis ; Swine ; Treatment Outcome</subject><ispartof>Annals of emergency medicine, 2005-10, Vol.46 (4), p.337-342</ispartof><rights>2005 American College of Emergency Physicians</rights><rights>2006 INIST-CNRS</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-dfd107602c83a1c7130020c2c15de716d602e720cf2661ecb25bd3ef88bd7e663</citedby><cites>FETCH-LOGICAL-c405t-dfd107602c83a1c7130020c2c15de716d602e720cf2661ecb25bd3ef88bd7e663</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,27924,27925</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=17252360$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/16187467$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Krismer, Anette C.</creatorcontrib><creatorcontrib>Wenzel, Volker</creatorcontrib><creatorcontrib>Lindner, Karl H.</creatorcontrib><creatorcontrib>Haslinger, Christopher W.</creatorcontrib><creatorcontrib>Oroszy, Stephan</creatorcontrib><creatorcontrib>Stadlbauer, Karl H.</creatorcontrib><creatorcontrib>Königsrainer, Alfred</creatorcontrib><creatorcontrib>Boville, Brian</creatorcontrib><creatorcontrib>Hörmann, Christoph</creatorcontrib><title>Influence of Positive End-Expiratory Pressure Ventilation on Survival During Severe Hemorrhagic Shock</title><title>Annals of emergency medicine</title><addtitle>Ann Emerg Med</addtitle><description>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<.0001). Ventilation with 0 cm H
2O PEEP prevented a further reduction of mean arterial blood pressure and cardiac output. When compared with the 0 cm H
2O PEEP group, end-tidal CO
2 declined in the 5 cm H
2O PEEP and 10 cm H
2O PEEP animals. Compared with the 0 cm H
2O PEEP animals, those ventilated with 5 or 10 cm H
2O PEEP had higher lactate levels after 10 minutes.
When compared with pigs ventilated with either 5 or 10 cm H
2O PEEP, those ventilated with 0 cm H
2O PEEP during untreated, severe hemorrhagic shock had significantly improved short-term survival.</description><subject>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</subject><subject>Animals</subject><subject>Biological and medical sciences</subject><subject>Blood Gas Analysis</subject><subject>Disease Models, Animal</subject><subject>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</subject><subject>Emergency and intensive respiratory care</subject><subject>Emergency Medicine - methods</subject><subject>Hemodynamics</subject><subject>Intensive care medicine</subject><subject>Medical sciences</subject><subject>Positive-Pressure Respiration - methods</subject><subject>Random Allocation</subject><subject>Shock, Hemorrhagic - blood</subject><subject>Shock, Hemorrhagic - physiopathology</subject><subject>Shock, Hemorrhagic - therapy</subject><subject>Survival Analysis</subject><subject>Swine</subject><subject>Treatment Outcome</subject><issn>0196-0644</issn><issn>1097-6760</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2005</creationdate><recordtype>article</recordtype><recordid>eNqNkVGL1DAQx4Mo3nr6FSQ-6FvXSdom7aOsq3dw4MGqryGbTPeytsmatMX79qbsoj4KfwhkfpMZfiHkDYM1AybeH9faexwwHga0aw5Qr4Hn8CdkxaCVhZACnpIVsFYUIKrqirxI6QgAbcXZc3LFBGtkJeSK4K3v-gm9QRo6eh-SG92MdOttsf11clGPIT7S-4gpTRHpd_Sj6_Xogqc5uynObtY9_ThF5w90hzNm6gaHEOODPjhDdw_B_HhJnnW6T_jqcl6Tb5-2Xzc3xd2Xz7ebD3eFqaAeC9tZBnl1bppSMyNZCcDBcMNqi5IJm0so803HhWBo9rze2xK7ptlbiUKU1-Td-d1TDD8nTKMaXDLY99pjmJISjSihaRewPYMmhpQiduoU3aDjo2KgFsfqqP5xrBbHCngOz72vL0Om_VL703mRmoG3F0Ano_suam9c-stJXvNSQOY2Zw6zktlhVMm45Susi2hGZYP7j3V-A4r9oYI</recordid><startdate>20051001</startdate><enddate>20051001</enddate><creator>Krismer, Anette C.</creator><creator>Wenzel, Volker</creator><creator>Lindner, Karl H.</creator><creator>Haslinger, Christopher W.</creator><creator>Oroszy, Stephan</creator><creator>Stadlbauer, Karl H.</creator><creator>Königsrainer, Alfred</creator><creator>Boville, Brian</creator><creator>Hörmann, Christoph</creator><general>Mosby, Inc</general><general>Elsevier</general><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20051001</creationdate><title>Influence of Positive End-Expiratory Pressure Ventilation on Survival During Severe Hemorrhagic Shock</title><author>Krismer, Anette C. ; Wenzel, Volker ; Lindner, Karl H. ; Haslinger, Christopher W. ; Oroszy, Stephan ; Stadlbauer, Karl H. ; Königsrainer, Alfred ; Boville, Brian ; Hörmann, Christoph</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-dfd107602c83a1c7130020c2c15de716d602e720cf2661ecb25bd3ef88bd7e663</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2005</creationdate><topic>Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy</topic><topic>Animals</topic><topic>Biological and medical sciences</topic><topic>Blood Gas Analysis</topic><topic>Disease Models, Animal</topic><topic>Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care</topic><topic>Emergency and intensive respiratory care</topic><topic>Emergency Medicine - methods</topic><topic>Hemodynamics</topic><topic>Intensive care medicine</topic><topic>Medical sciences</topic><topic>Positive-Pressure Respiration - methods</topic><topic>Random Allocation</topic><topic>Shock, Hemorrhagic - blood</topic><topic>Shock, Hemorrhagic - physiopathology</topic><topic>Shock, Hemorrhagic - therapy</topic><topic>Survival Analysis</topic><topic>Swine</topic><topic>Treatment Outcome</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Krismer, Anette C.</creatorcontrib><creatorcontrib>Wenzel, Volker</creatorcontrib><creatorcontrib>Lindner, Karl H.</creatorcontrib><creatorcontrib>Haslinger, Christopher W.</creatorcontrib><creatorcontrib>Oroszy, Stephan</creatorcontrib><creatorcontrib>Stadlbauer, Karl H.</creatorcontrib><creatorcontrib>Königsrainer, Alfred</creatorcontrib><creatorcontrib>Boville, Brian</creatorcontrib><creatorcontrib>Hörmann, Christoph</creatorcontrib><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Annals of emergency medicine</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Krismer, Anette C.</au><au>Wenzel, Volker</au><au>Lindner, Karl H.</au><au>Haslinger, Christopher W.</au><au>Oroszy, Stephan</au><au>Stadlbauer, Karl H.</au><au>Königsrainer, Alfred</au><au>Boville, Brian</au><au>Hörmann, Christoph</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Influence of Positive End-Expiratory Pressure Ventilation on Survival During Severe Hemorrhagic Shock</atitle><jtitle>Annals of emergency medicine</jtitle><addtitle>Ann Emerg Med</addtitle><date>2005-10-01</date><risdate>2005</risdate><volume>46</volume><issue>4</issue><spage>337</spage><epage>342</epage><pages>337-342</pages><issn>0196-0644</issn><eissn>1097-6760</eissn><coden>AEMED3</coden><abstract>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<.0001). Ventilation with 0 cm H
2O PEEP prevented a further reduction of mean arterial blood pressure and cardiac output. When compared with the 0 cm H
2O PEEP group, end-tidal CO
2 declined in the 5 cm H
2O PEEP and 10 cm H
2O PEEP animals. Compared with the 0 cm H
2O PEEP animals, those ventilated with 5 or 10 cm H
2O PEEP had higher lactate levels after 10 minutes.
When compared with pigs ventilated with either 5 or 10 cm H
2O PEEP, those ventilated with 0 cm H
2O PEEP during untreated, severe hemorrhagic shock had significantly improved short-term survival.</abstract><cop>New York, NY</cop><pub>Mosby, Inc</pub><pmid>16187467</pmid><doi>10.1016/j.annemergmed.2005.02.022</doi><tpages>6</tpages></addata></record> |
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| identifier | ISSN: 0196-0644 |
| ispartof | Annals of emergency medicine, 2005-10, Vol.46 (4), p.337-342 |
| issn | 0196-0644 1097-6760 |
| language | eng |
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| source | ScienceDirect Freedom Collection |
| subjects | Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy Animals Biological and medical sciences Blood Gas Analysis Disease Models, Animal Emergency and intensive cardiocirculatory care. Cardiogenic shock. Coronary intensive care Emergency and intensive respiratory care Emergency Medicine - methods Hemodynamics Intensive care medicine Medical sciences Positive-Pressure Respiration - methods Random Allocation Shock, Hemorrhagic - blood Shock, Hemorrhagic - physiopathology Shock, Hemorrhagic - therapy Survival Analysis Swine Treatment Outcome |
| title | Influence of Positive End-Expiratory Pressure Ventilation on Survival During Severe Hemorrhagic Shock |
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