Cardiopulmonary effects of positive end-expiratory pressure during one-lung ventilation in anesthetized dogs with a closed thoracic cavity

Objective-To evaluate the effects on oxygen delivery (Do,) of 2.5 and 5 cm H2O of positive end-expiratory pressure (PEEP) applied to the dependent lung during one-lung ventilation (OLV) in anesthetized dogs with a closed thoracic cavity. Animals-7 clinically normal adult Walker Hound dogs. Procedure-Dogs were anesthetized, and catheters were inserted in a dorsal pedal artery and the pulmonary artery. Dogs were positioned in right lateral recumbency, and data were collected during OLV (baseline), after application of 2.5 cm H2O Of PEEP for 15 minutes during OLV, and after application of 5 cm H2O of PEEP for 15 minutes during OLV. Hemodynamic and respiratory variables were analyzed and calculations performed to obtain DO2, and values were compared among the various time points by use of an ANOVA for repeated measures. Results-PEEP induced a significant decrease in shunt fraction that resulted in a significant increase in arterial oxygen saturation. However, it failed to significantly affect arterial oxygen content (Cao(2)) or cardiac output. Thus, Do(2) was not affected in healthy normoxemic dogs as a net result of the application of PEEP Conclusions and Clinical Relevance-The use of PEEP during OLV in anesthetized dogs with a closed thoracic cavity did not affect DO,. Use of PEEP during OLV in dogs with a closed thoracic cavity is recommended because it does not affect cardiac output and any gain in Cao(2) will be beneficial for Do(2) in critically ill patients.