Abstract
In order to meet metabolic demands, oxygen delivery(DO2)must be sufficient. However, in children with acute respiratory failure (ARF), DO2 is often partially estimated because cardiac output(CO) is rarely taken into account. This work reports the effects of mechanical ventilation with PEEP (CPPV) on DO2.
Methods : 7 newborns (GA : 34±2wks) with hyaline membrane disease and 3 children (5-10mos-12yrs) with ARF were evaluated. SaO2 was measured using Nellcor (tcSO2). The mean ascending aortic velocity was measured from suprasternal notch using a Pulsed-Doppler Vingmed SD-100 while the aortic diameter was measured at the aortic leaflets level. CO was automatically measured and averaged every 2.5 sec. Whithout modifying other settings, PEEP was stepwise increased and Paw, tcPO2, tcSO2 and CO were measured.
Thus, DO2 may be non-invasively measured in children. The stepwise increments in PEEP and Paw induced both an increase in arterial oxygenation and decrease in CO, leading to the concept of using the minimal effective or “optimal” PEEP in ARF.
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Mercier, J., Trang, H., Tibballs, J. et al. EFFECTS OF MECHANICAL VENTILATION WITH PEEP ON CARDIAC OUTPUT MEASURED USING PULSED DOPPLER IN CHILDREN. Pediatr Res 21 (Suppl 4), 204 (1987). https://doi.org/10.1203/00006450-198704010-00226
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DOI: https://doi.org/10.1203/00006450-198704010-00226