title: Noninvasive pulmonary blood flow for optimal PEEP.
abstract: Recent data in the literature suggest that effective pulmonary blood flow (Qp) measured invasively as cardiac output minus shunt flow, assumes its largest value at a PEEP level that is optimal in the sense that it also provides close to maximal oxygen delivery. Qp obtained noninvasively from simultaneous measurements of mixed expired and end-tidal CO2-concentrations is therefore proposed as a simple clinical indicator of the effects of PEEP on the cardio-pulmonary system. It is shown that modern respiratory equipment can be easily adapted to implement such a noninvasive evaluation of PEEP therapy. If the method is proven useful an automatic search for optimal PEEP becomes a future possibility.
mesh_terms: D006801:Humans; D008991:Monitoring, Physiologic / Q000295:instrumentation / Q000379:methods*; D010827:Physiology / Q000295:instrumentation; D011175:Positive-Pressure Respiration; D011652:Pulmonary Circulation