Hemodynamic effects of intermittent manual lung hyperinflation in patients with septic shock

• Published in: Heart & lung 2000-09, Vol.29 (5), p.356-366
• Main Authors: Jellema, Wilbert T., Groeneveld, A.B.Johan, van Goudoever, Jeroen, Wesseling, Karel H., Westerhof, Nico, Lubbers, Maarten J., Kesecioglu, Jozef, van Lieshout, Johannes J.
• Format: Article
• Language: English
• Subjects: Adult; Bacterial diseases; Bacterial sepsis; Biological and medical sciences; Cardiac Output; Contraindications; Female; Human bacterial diseases; Humans; Infectious diseases; Male; Medical sciences; Middle Aged; Prospective Studies; Respiration, Artificial - methods; Shock, Septic - physiopathology; Shock, Septic - therapy; Stroke Volume; Vascular Resistance; Ventricular Function, Left
• ISSN: 0147-9563; 1527-3288
• DOI: 10.1067/mhl.2000.109697

Objective: The purposes of this study were to investigate the hemodynamic changes induced by intermittent manual lung hyperinflation (MHI) and to assess if these changes are adverse enough to warrant prohibition of MHI as a routine procedure in the care of patients with septic shock. Design: The study’s design was experimental prospective. Setting: The settings were university hospital intensive care units. Patients: Subjects included 13 consecutive mechanically ventilated patients with septic shock who met the inclusion criteria. Measurements And Results: Phasic MHI-related increments in mean inspiratory airway pressure were concordant to changes in mean pulmonary artery pressure (MPAP) (r2 = 0.67) with a 0.6 mm Hg rise in MPAP per cm H2O airway pressure. The magnitude of MPAP changes was not reflected in magnitude of stroke volume index (SVI) (r2 = 0.06). On average, MHI did not induce statistically significant hemodynamic changes and mean values returned to baseline level within 15 minutes. SVI during MHI increased slightly in 9 patients, from 37 ± 15 (mean ± SD) to 41 ± 17 mL/m2 (P