1983
DOI: 10.1161/01.cir.68.2.266
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Cyclic changes in arterial pulse during respiratory support.

Abstract: In 13 patients on respiratory support we combined two-dimensional echocardiography with hemodynamic monitoring to determine the mechanism of cyclic changes in arterial pulse, defined as an inspiratory rise in radial artery pulse pressure. Beat-to-beat evaluation of cardiac performance was obtained during the following three distinct consecutive phases of the controlled respiratory cycle: exhalation (phase I), preinspiratory pause (phase LI), and lung inflation (phase III). Airway pressure, left ventricular fil… Show more

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Cited by 224 publications
(114 citation statements)
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“…Systolic blood pressure variation during the course of a respiratory cycle is similarly explained. 16 During 1:3 ventilation SBPV was present although less pronounced. This is not surprising, as it has been demonstrated previously that SBPV is more profound with coexistent hypovolaemia; 17 relative hypovolaemia exists at an I:E ratio ofl:l as is evident from the smaller EDAi.…”
Section: The Current Studymentioning
confidence: 94%
“…Systolic blood pressure variation during the course of a respiratory cycle is similarly explained. 16 During 1:3 ventilation SBPV was present although less pronounced. This is not surprising, as it has been demonstrated previously that SBPV is more profound with coexistent hypovolaemia; 17 relative hypovolaemia exists at an I:E ratio ofl:l as is evident from the smaller EDAi.…”
Section: The Current Studymentioning
confidence: 94%
“…Opening the chest cavity greatly reduces SPV [35] which implies that these interactions are highly dependent on cyclical intrathoracic pressure changes during mechanical ventilation. During lung inflation, a transient decrease in RV inflow [4,5] and increase in RV afterload [41] contribute to a transient decrease in RV stroke volume [4,5,42]. Simultaneously, lung inflation squeezes blood out of the pulmonary circulation into the left heart [9].…”
Section: Physiological Considerationsmentioning
confidence: 99%
“…Simultaneously, lung inflation squeezes blood out of the pulmonary circulation into the left heart [9]. Reduced RV inflow combined with increased LV inflow results in an increased transseptal pressure gradient which causes rightward septal shift (direct ventricular interaction) and increased LV preload despite the decreased sum of the ventricular diameters [4,5,42]. Although LV afterload is considered to decrease during lung inflation [10], much of the increase in systolic arterial pressure during inflation can be attributed to increased LV output because of the increased LV preload [43].…”
Section: Physiological Considerationsmentioning
confidence: 99%
“…Passive inspiration produces negative intrathoracic pressures, thereby increasing the capacitance of the pulmonary vasculature; this in turn may lead to a decreased left ventricular stoke volume and consequent decreased systemic arterial pressure. Increased capacitance of the pulmonary vasculature during inspiration leads to an expiratory increase in the left ventricular stoke volume and systemic arterial pressure after the pulmonary transit time [12,13]. These changes could be exploited as indices of fluid loading, but the usefulness of dynamic variables for assessment of fluid responsiveness during spontaneous breathing remains to be determined.…”
Section: Introductionmentioning
confidence: 99%