Skip Navigation
Menu
Letters |1 April 1994

Positive End-Expiratory Pressure and Shunting across Foramen Ovale

Mark D. Siegel, MD

Article, Author, and Disclosure Information
Author, Article, and Disclosure Information
  • Yale University School of Medicine; New Haven, CT 06520
×
FULL TEXT
TO THE EDITOR:
The study by Cujec and colleagues [1], showing that positive end-expiratory pressure (PEEP) increased right-to-left shunting in patients with a patent foramen ovale, raises several questions. First, did the echocardiographers know whether the patients were receiving PEEP? The interpretation of contrast echocardiograms is potentially subjective [2], and a nonblinded study is open to bias. Second, did the patients with and without a patent foramen ovale have similar functional residual capacities? The ability of PEEP to improve oxygen delivery varies among patients and correlates well with lower initial functional residual capacity [3]; therefore, this variable should have been controlled. Finally, how did the shunt increase in the patent foramen ovale group when the arterial and mixed venous oxygen remained the same [4]? More data on the arterial oxygenation of individual patients might clarify this paradox.
FULL TEXT
PDF
Not Available
Citations
Citation

Siegel MD. Positive End-Expiratory Pressure and Shunting across Foramen Ovale. Ann Intern Med. ;120:620. doi: 10.7326/0003-4819-120-7-199404010-00019

Download citation file:

© 2019

×
Permissions

Published: Ann Intern Med. 1994;120(7):620.

DOI: 10.7326/0003-4819-120-7-199404010-00019

0 Citations
CONTINUE WITH LIMITED ACCESS
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
acp link acp
silverchair link silverchair

Copyright © 2019 American College of Physicians. All Rights Reserved.

Print ISSN: 0003-4819 | Online ISSN: 1539-3704

Privacy Policy

|

Conditions of Use

This site uses cookies. By continuing to use our website, you are agreeing to our privacy policy. | Accept
×

You need a subscription to this content to use this feature.

×
PDF Downloads Require Access to the Full Article.
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×
Access to this Free Content Requires Users to be Registered and Logged In. Please Choose One of the Following Options
Annals of Internal Medicine
To receive access to the full text of freely available articles, alerts, and more. You will be directed to acponline.org to complete your registration.
×