Hoogenberg, R. (Ronald) (2017) Effects of mechanical ventilation on the cardiac index in pediatric patients : A prospective study on the effects of mechanical ventilation on the cardiac index in hemodynamically stable pediatric patients. thesis, Medicine.
Full text available on request.Abstract
Mechanical ventilation (MV) is widely used as a supportive treatment in pediatric patients whom are admitted to the pediatric intensive care unit (PICU). Where normal inspiration promotes venous return, the higher intrathoracic pressures (ITP) seen in MV could have a negative effect on the venous return and therefore on the cardiac function. However, the effect of MV on the cardiac index (CI) has not yet been evaluated in pediatric patients. Our primary objective was to evaluate the effect of MV with positive end expiratory pressure (PEEP) on the CI, stroke volume index (SVI), heart rate, blood pressure, and central venous pressure. We hypothesized that MV with PEEP levels up to 6 cm H2O would not cause a significant decrease CI or SVI in children who were weaning from ventilation when compared to spontaneous respiration after extubation. Between April 2017 and September 2017, we included 20 patients for our study. While the patient was receiving MV, we recorded the heart rate, blood pressure, saturation and central venous pressure from the monitor. After recording the vital signs, we determined the cardiac output, cardiac index and stroke volume using the Ultra Sonographic Cardiac Output Monitor (USCOM). We repeated the same measurement at a minimum of 15 minutes after the patient was extubated. A slight increase in CI after extubation was observed (from 4.2 to 4.3 l/min/m2), however this change was not found to be significant. We did however observe a slight but significant reduction in SVI after extubation (from 34 to 32 ml/m2). Heart rate however, was not significantly altered after extubation so the change in SVI could very well be caused by variations in probe placement. All children in this study were weaning from MV and therefore lower pressures were used. This study does show that lower pressures during MV does not have a negative effect on the cardiovascular function. Since higher pressured could still have a detrimental effect on the cardiovascular function, further studies are required to elucidate these effects.
| Item Type: | Thesis (Thesis) |
|---|---|
| Supervisor name: | Supervisor: and Kneijber, Dr. MCJ and Department: University Medical Centre Groningen Pediatric In |
| Faculty: | Medical Sciences |
| Date Deposited: | 25 Jun 2020 10:40 |
| Last Modified: | 25 Jun 2020 10:40 |
| URI: | https://umcg.studenttheses.ub.rug.nl/id/eprint/193 |
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