Tidal volume reduction in ARDS: Effect on cardiac output and arterial oxygenation

J. W. Leatherman, R. L. Lari, C. Iber, A. L. Ney

Research output: Contribution to journalArticlepeer-review

36 Scopus citations


During continuous positive pressure ventilation (CPPV), mean airway pressure and lung volume will be influenced both by the tidal volume (VT) employed and the amount of positive end-expiratory pressure (PEEP). The effect of varying levels of CPPV on PaO2 and cardiac output (Q) has been previously assessed by adjusting the level of PEEP at constant VT. This study examined the influence of a 200-ml reduction in VT, at a constant PEEP of 15 cm H2O, on the PaO2 and Q of 21 patients with adult respiratory distress syndrome (ARDS). The relationship between change in Q and change in total respiratory system compliance (Cst) after VT reduction was also examined. VT reduction from 14.1±0.8 ml/kg to 11.2±0.9 ml/kg yielded an increase in Q (+15±12 percent, p<0.01) without a significant change in PaO2 (-6.3±15.0 mm Hg, p = 0.08). Cst increased with VT reduction (+3.1±1.8 ml/cm H2O). There was only a modest correlation (r = +0.42, p = 0.06) between ΔQ percent and ΔCst following VT reduction. VT reduction at high level PEEP may yield a significant improvement in Q and net O2 delivery, but the degree of hemodynamic improvement is variable and is not reliably predicted noninvasively by measurement of Cst.

Original languageEnglish (US)
Pages (from-to)1227-1231
Number of pages5
Issue number5
StatePublished - 1991
Externally publishedYes


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