[Regional blood flow in splanchnic organs during positive end-expiratory pressure ventilation (author's transl)].

Abstract

An experimental study was performed on 10 dogs to evaluate the effect of positive end-expiratory pressure ventilation (PEEP) on hemodynamics and regional blood flow (RBF). The following conclusions can be drawn from the results of this study: 1) PEEP leads to a significant reduction of cardiac output (CO). 2) Total blood flow to the preportal splanchnic organs, and consequently the portal venous flow, decreases in proportion to the reduction of CO. Within the splanchnic area, there is a redistribution of RBF in favour of the small and large intestines, at the expense of stomach and pancreas. 3) The arterial blood flow to the liver is only moderately affected. 4) The observed changes of RBF may in part contribute to the complications of the splanchnic organs occurring in PEEP-ventilated patients. 5) PEEP should be used only when strictly indicated; close monitoring of organ function appears mandatory in these patients.