Heart-lung interactions: applications in the critically ill

Fessler, H

doi:10.1183/09031936.97.10010226

Cited by 53 publications

(46 citation statements)

References 109 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Recent publications suggest that the main effect by which PEEP decreases venous return is by increasing the resistance to venous return (R vr ) [14,15]. Hence, different PEEP levels should result in different values for R vr or more specifically, R vr should increase during elevated PEEP.…”

Section: Discussionmentioning

confidence: 99%

“…As a result, left ventricular afterload also decreases during PEEP as the pressure on the surface of the left ventricle is increased [14,15]. This LV afterload reduction is represented in the model as a decrease in systemic resistance (R sys ).…”

Section: Cvs Modelmentioning

confidence: 99%

“…Specifically, during the application of positive pressure ventilation (PPV) with PEEP, intrathoracic pressure increases and venous return is decreased. This decrease occurs not by altering the pressure gradient (P sys − P ra ), but by increasing the resistance to venous return R vr [14,15]. Hence, different PEEP levels should result in different values for R vr .…”

Section: Prediction Process and Peep-specific Model Parametersmentioning

confidence: 99%

“…Furthermore, it is also known that right ventricular afterload increases during PPV [14,15], so one would expect R pulin to also increase with increasing levels of PEEP.…”

Section: Prediction Process and Peep-specific Model Parametersmentioning

confidence: 99%

See 3 more Smart Citations

Prediction of hemodynamic changes towards PEEP titrations at different volemic levels using a minimal cardiovascular model

Starfinger

Chase

Hann

et al. 2008

Computer Methods and Programs in Biomedicine

View full text Add to dashboard Cite

(stroke volume). These results validate the general applicability of such a rule, which is not pig-specific, but holds over for all analyzed pigs. This rule enables physiological simulation and prediction of patient response. Overall, the prediction accuracy achieved represents a further clinical validation of these models, methods and overall approach to cardiovascular diagnosis and therapy guidance.

show abstract

Section: Discussionmentioning

confidence: 99%

Section: Cvs Modelmentioning

confidence: 99%

Section: Prediction Process and Peep-specific Model Parametersmentioning

confidence: 99%

“…Furthermore, it is also known that right ventricular afterload increases during PPV [14,15], so one would expect R pulin to also increase with increasing levels of PEEP.…”

Section: Prediction Process and Peep-specific Model Parametersmentioning

confidence: 99%

See 2 more Smart Citations

Prediction of hemodynamic changes towards PEEP titrations at different volemic levels using a minimal cardiovascular model

Starfinger

Chase

Hann

et al. 2008

Computer Methods and Programs in Biomedicine

View full text Add to dashboard Cite

show abstract

“…Patients with obstructive pulmonary diseases such as emphysema and asthma often demonstrate predictable ECG manifestations associated with abnormal lung mechanics [1,2,18]. Relatively acute pulmonary disease such as a pulmonary embolism can also impact the ECG [19].…”

Section: Discussionmentioning

confidence: 99%

Effects of Mechanical Ventilation on the Electrocardiogram in Adults

Elinoff

Talmor

Subramaniam

et al. 2008

Lung

View full text Add to dashboard Cite

The effects of mechanical ventilation on the surface electrocardiogram (ECG) have not been systematically investigated and the anticipated changes such as rightward P and QRS axes shifts, reduced QRS voltage, and slow R-wave progression are not supported by definitive data. We sought to determine the effects of mechanical ventilation on the surface ECG in hemodynamically stable adults without active cardiopulmonary disease. Seventeen patients in good overall health who were undergoing elective outpatient surgery had serial ECGs done preoperatively, intraoperatively, and postoperatively. No clinically significant changes in QRS or P-wave axis were detected. R-wave progression was not altered and there were no significant differences in the QRS amplitudes pre-, intra-, or postoperatively in either the precordial or limb leads. The present study shows that hemodynamically stable patients without active cardiopulmonary disease undergoing elective surgery demonstrate relatively minor ECG changes from baseline despite the addition of positive pressure ventilation. Clinicians should not assume that substantial changes in P wave or QRS axis or amplitude in patients undergoing mechanical ventilation are due to the effects of positive pressure ventilation alone.

show abstract

Lung Circulation

Suresh

Shimoda

2016

Comprehensive Physiology

111

View full text Add to dashboard Cite

The circulation of the lung is unique both in volume and function. For example, it is the only organ with two circulations: the pulmonary circulation, the main function of which is gas exchange, and the bronchial circulation, a systemic vascular supply that provides oxygenated blood to the walls of the conducting airways, pulmonary arteries and veins. The pulmonary circulation accommodates the entire cardiac output, maintaining high blood flow at low intravascular arterial pressure. As compared with the systemic circulation, pulmonary arteries have thinner walls with much less vascular smooth muscle and a relative lack of basal tone. Factors controlling pulmonary blood flow include vascular structure, gravity, mechanical effects of breathing, and the influence of neural and humoral factors. Pulmonary vascular tone is also altered by hypoxia, which causes pulmonary vasoconstriction. If the hypoxic stimulus persists for a prolonged period, contraction is accompanied by remodeling of the vasculature, resulting in pulmonary hypertension. In addition, genetic and environmental factors can also confer susceptibility to development of pulmonary hypertension. Under normal conditions, the endothelium forms a tight barrier, actively regulating interstitial fluid homeostasis. Infection and inflammation compromise normal barrier homeostasis, resulting in increased permeability and edema formation. This article focuses on reviewing the basics of the lung circulation (pulmonary and bronchial), normal development and transition at birth and vasoregulation. Mechanisms contributing to pathological conditions in the pulmonary circulation, in particular when barrier function is disrupted and during development of pulmonary hypertension, will also be discussed.

show abstract

Heart-lung interactions: applications in the critically ill

Cited by 53 publications

References 109 publications

Prediction of hemodynamic changes towards PEEP titrations at different volemic levels using a minimal cardiovascular model

Prediction of hemodynamic changes towards PEEP titrations at different volemic levels using a minimal cardiovascular model

Effects of Mechanical Ventilation on the Electrocardiogram in Adults

Lung Circulation

Contact Info

Product

Resources

About