Haemodynamic and endocrinological effects of noninvasive mechanical ventilation in respiratory failure.

Détails

ID Serval
serval:BIB_5CDB1D3D65A2
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Haemodynamic and endocrinological effects of noninvasive mechanical ventilation in respiratory failure.
Périodique
European Respiratory Journal
Auteur⸱e⸱s
Thorens J.B., Ritz M., Reynard C., Righetti A., Vallotton M., Favre H., Kyle U., Jolliet P., Chevrolet J.C.
ISSN
0903-1936 (Print)
ISSN-L
0903-1936
Statut éditorial
Publié
Date de publication
1997
Peer-reviewed
Oui
Volume
10
Numéro
11
Pages
2553-2559
Langue
anglais
Notes
Publication types: Journal ArticlePublication Status: ppublish
Résumé
The aim of this study was to investigate the haemodynamic and endocrinological effects of noninvasive positive pressure ventilation (NIPPV). Eleven patients with oedema and recent hypercapnic and hypoxaemic worsening of a chronic respiratory insufficiency were included. Echocardiography, cardiac radionuclide assessment, blood catecholamines, salt and water handling hormones were measured at admission and discharge (long study (LS)). To discriminate between the action of NIPPV and other treatments, measurements were performed on the fourth day, for 4 h without NIPPV and 4 h with NIPPV (short study (SS)). NIPPV entailed a correction of P(a,CO2) and an increase of P(a,O2) in LS and SS. Oedema disappeared. Body weight decreased (from 85+/-42 to 81+/-40 kg) during LS. Systolic and mean pulmonary arterial pressure decreased in LS and SS. Right ventricular ejection fraction increased in LS. Left ventricular ejection fraction did not change. Cardiac index was normal on admission and then decreased. Natriuretic peptides and catecholamines were increased on admission, whereas plasma renin activity, aldosterone and vasopressin were normal. We suggest that in these patients, oedema can occur independently of renin-angiotensin-aldosterone-vasopressin and with a normal cardiac output. Noninvasive positive pressure ventilation allowed a correction of blood gases, associated with the resolution of oedema, a decrease in pulmonary arterial pressures and an increase in right ventricular ejection fraction.
Mots-clé
Atrial Natriuretic Factor/blood, Body Composition, Case-Control Studies, Edema/physiopathology, Female, Hemodynamics/physiology, Hormones/blood, Humans, Hypercapnia/physiopathology, Intermittent Positive-Pressure Ventilation/methods, Male, Middle Aged, Natriuretic Peptide, Brain, Nerve Tissue Proteins/blood, Pulmonary Wedge Pressure/physiology, Respiratory Insufficiency/physiopathology, Respiratory Insufficiency/therapy, Ventricular Function, Right/physiology, Water-Electrolyte Balance/physiology
Pubmed
Web of science
Création de la notice
27/06/2013 16:04
Dernière modification de la notice
20/08/2019 15:15
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