Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation

Introduction: Finding the probable governing pattern of PEEP and CVP changes is an area of interest for in-charge physicians and researchers. Therefore, the present study was designed with the aim of evaluating the relationship between the mentioned pressures. Methods: In this quasi-experimental...

Full description

Bibliographic Details
Main Authors: Majid Shojaee, Anita Sabzghabaei, Hossein Alimohammadi, Hojjat Derakhshanfar, Afshin Amini, Bahareh Esmailzadeh
Format: Article
Language:English
Published: Shahid Beheshti University of Medical Sciences 2018-12-01
Series:Archives of Academic Emergency Medicine
Subjects:
Online Access:https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/103
_version_ 1828776933522931712
author Majid Shojaee
Anita Sabzghabaei
Hossein Alimohammadi
Hojjat Derakhshanfar
Afshin Amini
Bahareh Esmailzadeh
author_facet Majid Shojaee
Anita Sabzghabaei
Hossein Alimohammadi
Hojjat Derakhshanfar
Afshin Amini
Bahareh Esmailzadeh
author_sort Majid Shojaee
collection DOAJ
description Introduction: Finding the probable governing pattern of PEEP and CVP changes is an area of interest for in-charge physicians and researchers. Therefore, the present study was designed with the aim of evaluating the relationship between the mentioned pressures. Methods: In this quasi-experimental study, patients under mechanical ventilation were evaluated with the aim of assessing the effect of PEEP change on CVP. Non-trauma patients, over 18 years of age, who were under mechanical ventilation and had stable hemodynamics, with inserted CV line were entered. After gathering demographic data, patients underwent 0, 5, and 10 cmH2O PEEPs and the respective CVPs of the mentioned points were recorded. The relationship of CVP and PEEP in different cut points were measured using SPSS 21.0 statistical software. Results: 60 patients with the mean age of 73.95 ± 11.58 years were evaluated (68.3% male). The most frequent cause of ICU admission was sepsis with 45.0%. 5 cmH2O increase in PEEP led to 2.47 ± 1.53 mean difference in CVP level. If the PEEP baseline is 0 at the time of 5 cmH2O increase, it leads to a higher raise in CVP compared to when the baseline is 5 cmH2O (2.47 ± 1.53 vs. 1.57 ± 1.07; p = 0.039). The relationship between CVP and 5 cmH2O (p = 0.279), and 10 cmH2O (p = 0.292) PEEP changes were not dependent on the baseline level of CVP. Conclusion: The findings of this study revealed the direct relationship between PEEP and CVP. Approximately, a 5 cmH2O increase in PEEP will be associated with about 2.5 cmH2O raise in CVP. When applying a 5 cmH2O PEEP increase, if the baseline PEEP is 0, it leads to a significantly higher raise in CVP compared to when it is 5 cmH2O (2.5 vs. 1.6). It seems that sex, history of cardiac failure, baseline CVP level, and hypertension do not have a significant effect in this regard.
first_indexed 2024-12-11T16:11:18Z
format Article
id doaj.art-a5f40c40d5a34bb4901a0df13c1bc374
institution Directory Open Access Journal
issn 2645-4904
language English
last_indexed 2024-12-11T16:11:18Z
publishDate 2018-12-01
publisher Shahid Beheshti University of Medical Sciences
record_format Article
series Archives of Academic Emergency Medicine
spelling doaj.art-a5f40c40d5a34bb4901a0df13c1bc3742022-12-22T00:59:04ZengShahid Beheshti University of Medical SciencesArchives of Academic Emergency Medicine2645-49042018-12-015110.22037/aaem.v5i1.103Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical VentilationMajid Shojaee0Anita Sabzghabaei1Hossein Alimohammadi2Hojjat Derakhshanfar3Afshin Amini4Bahareh Esmailzadeh5Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Department of Emergency Medicine, Loghmane Hakim Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Department of Emergency Medicine, Imam Hossein Hospital, Shahid Beheshti University of Medical Sciences, Tehran, Iran.Introduction: Finding the probable governing pattern of PEEP and CVP changes is an area of interest for in-charge physicians and researchers. Therefore, the present study was designed with the aim of evaluating the relationship between the mentioned pressures. Methods: In this quasi-experimental study, patients under mechanical ventilation were evaluated with the aim of assessing the effect of PEEP change on CVP. Non-trauma patients, over 18 years of age, who were under mechanical ventilation and had stable hemodynamics, with inserted CV line were entered. After gathering demographic data, patients underwent 0, 5, and 10 cmH2O PEEPs and the respective CVPs of the mentioned points were recorded. The relationship of CVP and PEEP in different cut points were measured using SPSS 21.0 statistical software. Results: 60 patients with the mean age of 73.95 ± 11.58 years were evaluated (68.3% male). The most frequent cause of ICU admission was sepsis with 45.0%. 5 cmH2O increase in PEEP led to 2.47 ± 1.53 mean difference in CVP level. If the PEEP baseline is 0 at the time of 5 cmH2O increase, it leads to a higher raise in CVP compared to when the baseline is 5 cmH2O (2.47 ± 1.53 vs. 1.57 ± 1.07; p = 0.039). The relationship between CVP and 5 cmH2O (p = 0.279), and 10 cmH2O (p = 0.292) PEEP changes were not dependent on the baseline level of CVP. Conclusion: The findings of this study revealed the direct relationship between PEEP and CVP. Approximately, a 5 cmH2O increase in PEEP will be associated with about 2.5 cmH2O raise in CVP. When applying a 5 cmH2O PEEP increase, if the baseline PEEP is 0, it leads to a significantly higher raise in CVP compared to when it is 5 cmH2O (2.5 vs. 1.6). It seems that sex, history of cardiac failure, baseline CVP level, and hypertension do not have a significant effect in this regard.https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/103Positive-pressure respirationcentral venous pressureventilatorsmechanicalcatheterizationcentral venous
spellingShingle Majid Shojaee
Anita Sabzghabaei
Hossein Alimohammadi
Hojjat Derakhshanfar
Afshin Amini
Bahareh Esmailzadeh
Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation
Archives of Academic Emergency Medicine
Positive-pressure respiration
central venous pressure
ventilators
mechanical
catheterization
central venous
title Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation
title_full Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation
title_fullStr Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation
title_full_unstemmed Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation
title_short Effect of Positive End-Expiratory Pressure on Central Venous Pressure in Patients under Mechanical Ventilation
title_sort effect of positive end expiratory pressure on central venous pressure in patients under mechanical ventilation
topic Positive-pressure respiration
central venous pressure
ventilators
mechanical
catheterization
central venous
url https://journals.sbmu.ac.ir/aaem/index.php/AAEM/article/view/103
work_keys_str_mv AT majidshojaee effectofpositiveendexpiratorypressureoncentralvenouspressureinpatientsundermechanicalventilation
AT anitasabzghabaei effectofpositiveendexpiratorypressureoncentralvenouspressureinpatientsundermechanicalventilation
AT hosseinalimohammadi effectofpositiveendexpiratorypressureoncentralvenouspressureinpatientsundermechanicalventilation
AT hojjatderakhshanfar effectofpositiveendexpiratorypressureoncentralvenouspressureinpatientsundermechanicalventilation
AT afshinamini effectofpositiveendexpiratorypressureoncentralvenouspressureinpatientsundermechanicalventilation
AT baharehesmailzadeh effectofpositiveendexpiratorypressureoncentralvenouspressureinpatientsundermechanicalventilation