Effects of extrathoracic mechanical ventilation on pulmonary hypertension secondary to lung diseaseReportar como inadecuado




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Journal of Anesthesia

, Volume 30, Issue 4, pp 663–670

First Online: 18 April 2016Received: 19 November 2014Accepted: 03 April 2016

Abstract

PurposeBiphasic cuirass ventilation BCV is a form of non-invasive extrathoracic positive and negative pressure mechanical ventilation. The present study was conducted to quantify our positive experience using BCV to dramatically improve gas exchange and cardiac function in patients with acute exacerbation of chronic respiratory failure and secondary pulmonary hypertension PH.

MethodsBCV was applied for 2 weeks in 17 patients with PH caused by lung disease. Ventilation sessions were limited to 1 h per day to prevent exhaustion. To assess respiratory and circulatory effects, percutaneous arterial oxygen saturation SpO2 was measured before and after each daily BCV session, and right heart catheter test mean pulmonary artery pressure mPAP, right atrium pressure RAP, pulmonary artery occlusion pressure PAOP and cardiac index CI and serum N-terminal pro-brain natriuretic peptide NT-proBNP were measured before and after a series of BCV sessions.

ResultsSpO2 transiently improved after each BCV session. After a series of BCV, mPAP decreased from 27.2 to 22.4 mmHg p = 0.0007. PAOP, CI and serum NT-proBNP levels decreased compared with baseline. No patients were treated with epoprostenol, iloprost, bosentan or sildenafil for PH.

ConclusionBCV may improve circulatory function in patients with PH caused by lung disease.

KeywordsBiphasic cuirass ventilation Pulmonary hypertension Ventilator Electronic supplementary materialThe online version of this article doi:10.1007-s00540-016-2172-7 contains supplementary material, which is available to authorized users.

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Autor: Yoko Sato - Noriyuki Saeki - Takuma Asakura - Kazutetsu Aoshiba - Toru Kotani

Fuente: https://link.springer.com/







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