Interaction between Positive End Expiratory Pressure and Cardiac Index

Frontiers in Pediatrics

Maroun J. Mhanna¹ 

关键词: positive end-expiratory pressure;    cardiac index;    oxygen transport;    critically ill children;    infants;   

DOI  :  10.3389/fped.2015.00005

学科分类：儿科学

来源: Frontiers

【 摘 要 】

Positive end-expiratory pressure (PEEP) is essential in the management of acute respiratory failure (ARF) and acute respiratory distress syndrome (ARDS) in children and adults. Several studies have addressed the pulmonary beneficial effect and cardiovascular impact of an elevated PEEP in adults. However, the impact of an elevated PEEP on the respiratory and cardiovascular systems has not been well elucidated in children. The compliance of the total respiratory system and its components differs between newborn infants, toddlers, children, and adults. For instance, the compliance of the chest wall (as a major component of the total respiratory system) decreases with advancing age (1). Therefore, tolerated elevated levels of PEEP in adults may not be tolerated in children. Similarly, the cardiovascular physiology differs between children and adults. For instance, the systemic vascular resistance (SVR) is higher at baseline in children than adults, and the heart rate (a major component of the cardiac output) is higher in children than adults. Therefore, extrapolating adult physiological studies to children is misleading. Studies addressing the impact of PEEP on the respiratory mechanics and cardiovascular system in children are needed.

【 授权许可】

CC BY