Effects of positive end-expiratory pressure ventilation on cerebral venous pressure with head elevation in dogs

Thomas J Toung, H. Aizawa, Richard J. Traystman

Research output: Contribution to journalArticle

Abstract

Mechanical ventilation with positive end-expiratory pressure (PEEP) may prevent venous air embolism in the sitting position because cerebral venous pressure (Pcev) could be increased by the PEEP-induced increase in right atrial pressure (Pra). Whereas it is clear that there is a linear transmission of the PEEP-induced increase in Pra to Pcev while the dog is in the prone position, the mechanism of the transmission with the dog in the head-elevated position is unclear. We tested the hypothesis that a Starling resistor-type mechanism exists in the jugular veins when the head is elevated. In one group of dogs, increasing PEEP linearly increased Pcev with the dog in the prone position (head at heart level, slope = 0.851) but did not increase Pcev when the head was elevated. In another group of dogs, an external chest binder was used to produce a larger PEEP-induced increase in Pra. Further increasing Pra increased Pcev only after Pra exceeded a pressure of 19 mmHg (break pressure). This sharp inflection in the upstream (Pcev)- downstream (Pra) relationship suggests that this may be caused by a Starling resistor-type mechanism. We conclude that jugular venous collapse serves as a significant resistance in the transmission of Pra to Pcev in the head- elevated position.

Original languageEnglish (US)
Pages (from-to)655-661
Number of pages7
JournalJournal of Applied Physiology
Volume88
Issue number2
StatePublished - Feb 2000

Fingerprint

Venous Pressure
Positive-Pressure Respiration
Head
Dogs
Starlings
Prone Position
Pressure
Air Embolism
Atrial Pressure
Jugular Veins
Posture
Artificial Respiration
Neck
Thorax

Keywords

  • Chest hinder
  • Intracranial pressure
  • Jugular venous pressure
  • Right atrial pressure
  • Starling resistor

ASJC Scopus subject areas

  • Physiology
  • Endocrinology
  • Orthopedics and Sports Medicine
  • Physical Therapy, Sports Therapy and Rehabilitation

Cite this

Effects of positive end-expiratory pressure ventilation on cerebral venous pressure with head elevation in dogs. / Toung, Thomas J; Aizawa, H.; Traystman, Richard J.

In: Journal of Applied Physiology, Vol. 88, No. 2, 02.2000, p. 655-661.

Research output: Contribution to journalArticle

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