Emergency ventilatory management in hemorrhagic states: Elemental or Detrimental?

Paul E. Pepe; Claus Raedler; Keith G. Lurie; Jane G. Wigginton

doi:10.1097/01.TA.0000064280.05372.7C

Emergency ventilatory management in hemorrhagic states: Elemental or Detrimental?

Paul E. Pepe, Claus Raedler, Keith G. Lurie, Jane G. Wigginton

Research output: Contribution to journal › Article › peer-review

66 Scopus citations

Abstract

Methods:Eight swine (ventilated with 12 mL/kg tidal volume, 0.28 FIO_SB; RR of 12 breaths/min) were hemorrhaged to < 65 mm Hg systolic arterial blood pressure (SABP). RRs were then sequentially changed every 10 minutes to 6, 20, 30, and 6 breaths/min.Results:With RRs at 6 breaths/min, the animals maintained pH > 7.25/SaO₂ > 99%, but increased mean SABP (from 65 to 84 mm Hg; p < 0.05), time-averaged coronary perfusion pressure (CPP) (from 50 ± 2 to 60 ± 4 mm Hg; p < 0.05), and cardiac output (Qt) (from 2.4 to 2.8 L/min; p < 0.05). With RRs of 20 and 30 breaths/min, SABP (73 and 66 mm Hg), CPP (47 ± 3 and 42 ± 4 mm Hg), and Qt (2.5 and 2.4 L/min) decreased, as did PaO₂ and PaCO₂ (< 30 mm Hg), with p < 0.05 for each comparison, respectively. When RR returned to 6 breaths/min, SABP (95 mm Hg), CPP (71 ± 6 mm Hg), and Qt (3.0 L/min) improved significantly (p < 0.05).

Original language	English (US)
Pages (from-to)	1048-1057
Number of pages	10
Journal	Journal of Trauma
Volume	54
Issue number	6
DOIs	https://doi.org/10.1097/01.TA.0000064280.05372.7C
State	Published - Jun 2003
Externally published	Yes

Keywords

Auto-positive end-expiratory pressure
Cardiac arrest
Coronary perfusion pressure
Hemodynamics
Hemorrhage
Hemorrhagic shock
Hypovolemia
Mechanical ventilation
Positive-pressure ventilation
Preload
Respiratory support
Resuscitation
Shock
Venous return
Ventilation

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10.1097/01.TA.0000064280.05372.7C

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@article{192f4083b7004f2a93ee1b3e50666973,

title = "Emergency ventilatory management in hemorrhagic states: Elemental or Detrimental?",

abstract = "Methods:Eight swine (ventilated with 12 mL/kg tidal volume, 0.28 FIOSB; RR of 12 breaths/min) were hemorrhaged to < 65 mm Hg systolic arterial blood pressure (SABP). RRs were then sequentially changed every 10 minutes to 6, 20, 30, and 6 breaths/min.Results:With RRs at 6 breaths/min, the animals maintained pH > 7.25/SaO2 > 99%, but increased mean SABP (from 65 to 84 mm Hg; p < 0.05), time-averaged coronary perfusion pressure (CPP) (from 50 ± 2 to 60 ± 4 mm Hg; p < 0.05), and cardiac output (Qt) (from 2.4 to 2.8 L/min; p < 0.05). With RRs of 20 and 30 breaths/min, SABP (73 and 66 mm Hg), CPP (47 ± 3 and 42 ± 4 mm Hg), and Qt (2.5 and 2.4 L/min) decreased, as did PaO2 and PaCO2 (< 30 mm Hg), with p < 0.05 for each comparison, respectively. When RR returned to 6 breaths/min, SABP (95 mm Hg), CPP (71 ± 6 mm Hg), and Qt (3.0 L/min) improved significantly (p < 0.05).",

keywords = "Auto-positive end-expiratory pressure, Cardiac arrest, Coronary perfusion pressure, Hemodynamics, Hemorrhage, Hemorrhagic shock, Hypovolemia, Mechanical ventilation, Positive-pressure ventilation, Preload, Respiratory support, Resuscitation, Shock, Venous return, Ventilation",

author = "Pepe, {Paul E.} and Claus Raedler and Lurie, {Keith G.} and Wigginton, {Jane G.}",

year = "2003",

month = jun,

doi = "10.1097/01.TA.0000064280.05372.7C",

language = "English (US)",

volume = "54",

pages = "1048--1057",

journal = "Journal of Trauma",

issn = "0022-5282",

publisher = "Lippincott Williams and Wilkins",

number = "6",

}

TY - JOUR

T1 - Emergency ventilatory management in hemorrhagic states

T2 - Elemental or Detrimental?

AU - Pepe, Paul E.

AU - Raedler, Claus

AU - Lurie, Keith G.

AU - Wigginton, Jane G.

PY - 2003/6

Y1 - 2003/6

N2 - Methods:Eight swine (ventilated with 12 mL/kg tidal volume, 0.28 FIOSB; RR of 12 breaths/min) were hemorrhaged to < 65 mm Hg systolic arterial blood pressure (SABP). RRs were then sequentially changed every 10 minutes to 6, 20, 30, and 6 breaths/min.Results:With RRs at 6 breaths/min, the animals maintained pH > 7.25/SaO2 > 99%, but increased mean SABP (from 65 to 84 mm Hg; p < 0.05), time-averaged coronary perfusion pressure (CPP) (from 50 ± 2 to 60 ± 4 mm Hg; p < 0.05), and cardiac output (Qt) (from 2.4 to 2.8 L/min; p < 0.05). With RRs of 20 and 30 breaths/min, SABP (73 and 66 mm Hg), CPP (47 ± 3 and 42 ± 4 mm Hg), and Qt (2.5 and 2.4 L/min) decreased, as did PaO2 and PaCO2 (< 30 mm Hg), with p < 0.05 for each comparison, respectively. When RR returned to 6 breaths/min, SABP (95 mm Hg), CPP (71 ± 6 mm Hg), and Qt (3.0 L/min) improved significantly (p < 0.05).

AB - Methods:Eight swine (ventilated with 12 mL/kg tidal volume, 0.28 FIOSB; RR of 12 breaths/min) were hemorrhaged to < 65 mm Hg systolic arterial blood pressure (SABP). RRs were then sequentially changed every 10 minutes to 6, 20, 30, and 6 breaths/min.Results:With RRs at 6 breaths/min, the animals maintained pH > 7.25/SaO2 > 99%, but increased mean SABP (from 65 to 84 mm Hg; p < 0.05), time-averaged coronary perfusion pressure (CPP) (from 50 ± 2 to 60 ± 4 mm Hg; p < 0.05), and cardiac output (Qt) (from 2.4 to 2.8 L/min; p < 0.05). With RRs of 20 and 30 breaths/min, SABP (73 and 66 mm Hg), CPP (47 ± 3 and 42 ± 4 mm Hg), and Qt (2.5 and 2.4 L/min) decreased, as did PaO2 and PaCO2 (< 30 mm Hg), with p < 0.05 for each comparison, respectively. When RR returned to 6 breaths/min, SABP (95 mm Hg), CPP (71 ± 6 mm Hg), and Qt (3.0 L/min) improved significantly (p < 0.05).

KW - Auto-positive end-expiratory pressure

KW - Cardiac arrest

KW - Coronary perfusion pressure

KW - Hemodynamics

KW - Hemorrhage

KW - Hemorrhagic shock

KW - Hypovolemia

KW - Mechanical ventilation

KW - Positive-pressure ventilation

KW - Preload

KW - Respiratory support

KW - Resuscitation

KW - Shock

KW - Venous return

KW - Ventilation

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U2 - 10.1097/01.TA.0000064280.05372.7C

DO - 10.1097/01.TA.0000064280.05372.7C

M3 - Article

C2 - 12813322

AN - SCOPUS:0038801377

SN - 0022-5282

VL - 54

SP - 1048

EP - 1057

JO - Journal of Trauma

JF - Journal of Trauma

IS - 6

ER -

Emergency ventilatory management in hemorrhagic states: Elemental or Detrimental?

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