Objective: We tested whether alternating ventilation (AV) of each lung (i.e. with a phase difference of half a ventilatory cycle) would decrease central venous pressure and so increase cardiac output when compared with simultaneous ventilation (SV) of both lungs. Theory: If, during AV, the inflated lung expands partly via compression of the opposite lung, mean lung volume will be smaller during AV than SV. As a consequence, mean intrathoracic pressure (as cited in the literature), and therefore, central venous pressure will be smaller. Design: The experiments were performed in seven anaesthetized and paralyzed piglets using a double-piston ventilator. Minute ventilation was the same during AV and SV. Starting at SV, we alternated three times between AV and SV for periods of 10 min. Results: During AV, central venous pressure was decreased by 0.7 mmHg and cardiac output was increased by 10±4.4% (mean, ±SD) compared with SV. AV also resulted in increased arterial pressure. During one-sided inflation with closed outlet of the opposite lung, a pressure rise occurred in the opposite lung, indicating compression. Conclusion: The higher cardiac output during AV than SV can be explained by the fact that central venous pressure is lower during AV. This lower central venous pressure is very probably due to the lower mean intrathoracic pressure caused by compression of the opposite lung during unilateral inflation.

Alternating ventilation, Cardiac output, Central venous pressure
dx.doi.org/10.1007/BF01700663, hdl.handle.net/1765/65583
Intensive Care Medicine
Department of Pulmonology

Versprille, A, Hrachovina, V, & Jansen, J.R.C. (1995). Alternating versus synchronous ventilation of left and right lungs in piglets. Intensive Care Medicine, 21(12), 1009–1015. doi:10.1007/BF01700663