Combined effects of Inversed Ratio Ventilation (IRV) with positive end-expiratory pressure ventilation (PEEP) on cardiorespiratory function in acute respiratory failure |
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Authors: | Atsuo Sari Takashi Toriumi Shigeki Yamashita Tadahiko Nonoue Shiro Kojima Kohji Kawai Akitomo Yonei |
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Institution: | (1) Department of Anesthesia, Kurashiki Central Hospital, Okayama, Japan;(2) Department of Anesthesia, Kurashiki Central Hospital, 1-1-1 Miwa, Kurashiki, Okayama, 710, Japan |
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Abstract: | Combined effects of inversed ratio ventilation (IRV) with positive end-expiratory pressure (PEEP) on cardiorespiratory function were examined in 24 patients with acute respiratory failure. Patients were divided into two groups: the IRV group (n = 12) who showed no significant increase in PaO
2 with a 6cmH2O of PEEP and PEEP group (n = 12) who were ventilated mechanically with PEEP only at maximum level of 10cmH2O. In IRV group step-wise prolongation of the I:E ratio from 1:1.9 to 2.6:1 or 4:1 was applied as a PaO
2 was improved and in PEEP group also level of PEEP was increased from 0, 5 to 10cmH2O after one hour period irrespective of PaO
2. Inversed ratio ventilation and PEEP increased significantly PaO
2/Fi
O
2, the increase being observed 6hrs (I:E = 2:1) and 2hrs (10cmH2O) after starting IRV or PEEP. Further improvement of oxygenation was not observed in IRV even if I:E ratio was prolonged up to 2.6:1 or 4:1. These results suggested that combinations of IRV with PEEP were effective and an I:E ratio of 2:1 may be optimal, and IRV is advantageous compared to PEEP, but will take more long time to improve oxygenation than PEEP.(Sari A, Toriumi T, Yamashita S, et al.: Combined effects of inversed ratio ventilation (IRV) with positive end-expiratory pressure ventilation (PEEP) on cardiorespiratory function in acute respiratory failure. J Anesth 5: 105–113, 1991) |
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Keywords: | Mechanical ventilation IRV I:gif" alt="thinsp" align="MIDDLE" BORDER="0">:E ratio" target="_blank">gif" alt="thinsp" align="MIDDLE" BORDER="0">E ratio PEEP Cardiac output Oxygen delivery |
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