Mechanisms of impaired renal function with PEEP

Richard J. Mullins, Elizabeth J. Dawe, Charles E. Lucas, Anna M. Ledgerwood, Steven M. Banks

Research output: Contribution to journalArticlepeer-review

17 Scopus citations

Abstract

Deterioration in renal function associated with positive end-expiratory pressure (PEEP) has been attributed to renal hypoperfusion from the fall in cardiac output and mean arterial blood pressure. Using a canine in vivo model, renal function was measured during control, zero end-expiratory pressure (ZEEP), and PEEP (5, 10, and 15 cm H2O) ventilatory cycles, while renal blood flow was maintained constant with a pump. High PEEP (15 cm H2O) led to a rise in renal vein pressure (RVP) and a fall in mean arterial pressure (MAP). PEEP resulted in no change in glomerular filtration rate (GFR) or solute exertion; however, free-water clearance (FWC) became less negative in the 15-cm H2O PEEP group. Intrarenal autoregulation maintains GFR during ventilation with PEEP when renal blood flow is constant, supporting the view that altered filtration and solute excretion clinically is secondary to changes in aortic pressure and renal perfusion.

Original languageEnglish (US)
Pages (from-to)189-196
Number of pages8
JournalJournal of Surgical Research
Volume37
Issue number3
DOIs
StatePublished - Sep 1984

ASJC Scopus subject areas

  • Surgery

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