Hemodynamic Consequences of Heart-Lung Interactions

Steingrub, Jay S.; Tidswell, Mark; Higgins, Thomas L.

doi:10.1177/0885066602250369

Cited by 47 publications

(33 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…Hi-NPPV in most cases) leads to a positive swing in Ppl during inspiration and, therefore, a higher right atrial pressure, which leads to decreased venous return and, consequently, a decreased right atrial preload. Moreover, the elevated lung volume during Hi-NPPV may have increased pulmonary vascular resistance [8,9].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Physiological changes during low- and high-intensity noninvasive ventilation

Lukácsovits¹,

Carlucci²,

Hill³

et al. 2011

Eur Respir J

View full text Add to dashboard Cite

In a physiological randomised cross-over study performed in stable hypercapnic chronic obstructive disease patients, we assessed the short-term effects of two settings of noninvasive ventilation.One setting was aimed at maximally reducing arterial carbon dioxide tension (Pa,CO 2 ) (highintensity ( We conclude that while Hi-NPPV is more effective than Li-NPPV in improving gas exchange and in reducing inspiratory effort, it induces a marked reduction in CO, which needs to be considered when Hi-NPPV is applied to patients with pre-existing cardiac disease.

show abstract

Section: Discussionmentioning

confidence: 99%

“…Moreover, through an increase in intrathoracic pressure, Hi-NPPV could reduce cardiac output (CO) [8,9].…”

Section: Abstract: Chronic Obstructive Pulmonary Disease Noninvasivementioning

confidence: 99%

Physiological changes during low- and high-intensity noninvasive ventilation

Lukácsovits¹,

Carlucci²,

Hill³

et al. 2011

Eur Respir J

View full text Add to dashboard Cite

show abstract

“…Furthermore, even if SV is initially maintained, an increase in CO will decrease central venous pressure, thereby, decreasing right ventricular filling pressure, which would ultimately limit the ability to sustain left ventricular SV and, therefore, sustain the rise in CO (6,30,40). Because of the capacitance of the pulmonary circulation, the fall in the ventricular filling does take time to occur, and therefore, transient changes in HR can still cause transient changes in CO (42). This may be particularly important in compensating for rapid changes in arterial pressure, inasmuch as the parasympathetically mediated rapid HR responses and subsequent transient CO changes can occur quickly, thereby protecting pressure while the slower but sustained sympathetically mediated vascular responses develop (22,32).…”

Section: Discussionmentioning

confidence: 99%

Dynamic cardiac output regulation at rest, during exercise, and muscle metaboreflex activation: impact of congestive heart failure

Ichinose

Sala‐Mercado

Coutsos

et al. 2012

American Journal of Physiology-Regulatory, Integrative and Comp

View full text Add to dashboard Cite

.2012.-We tested whether mild and moderate dynamic exercise and muscle metaboreflex activation (MMA) affect dynamic baroreflex control of heart rate (HR) and cardiac output (CO), and the influence of stroke volume (SV) fluctuations on CO regulation in normal (N) and pacing-induced heart failure (HF) dogs by employing transfer function analyses of the relationships between spontaneous changes in left ventricular systolic pressure (LVSP) and HR, LVSP and CO, HR and CO, and SV and CO at low and high frequencies (Lo-F, 0.04 -0.15 Hz; Hi-F, 0.15-0.6 Hz). In N dogs, both workloads significantly decreased the gains for LVSP-HR and LVSP-CO in Hi-F, whereas only moderate exercise also reduced the LVSP-CO gain in Lo-F. MMA during mild exercise further decreased the gains for LVSP-HR in both frequencies and for LVSP-CO in Lo-F. MMA during moderate exercise further reduced LVSP-HR gain in Lo-F. Coherence for HR-CO in Hi-F was decreased by exercise and MMA, whereas that in Lo-F was sustained at a high level (Ͼ0.8) in all settings. HF significantly decreased dynamic HR and CO regulation in all situations. In HF, the coherence for HR-CO in Lo-F decreased significantly in all settings; the coherence for SV-CO in Lo-F was significantly higher. We conclude that dynamic exercise and MMA reduces dynamic baroreflex control of HR and CO, and these are substantially impaired in HF. In N conditions, HR modulation plays a major role in CO regulation. In HF, influence of HR modulation wanes, and fluctuations of SV dominate in CO variations. arterial baroreflex; exercise reflexes; pressor response; impaired cardiac performance BEAT-TO-BEAT CARDIAC OUTPUT (CO) varies considerably across successive heart beats, whereas the average level remains remarkably constant under basal conditions (21, 50). This likely involves control mechanisms operating at markedly different frequencies. Rapid baroreflex control of heart rate (HR) is thought to play a crucial role in dynamic CO regulation. Previous studies suggest that low-frequency (Lo-F: 0.04 -0.15 Hz) blood pressure fluctuations are buffered by the dynamic baroreflex control of HR (25, 28). However, we and others have observed that changes in HR do not necessarily elicit proportional changes in CO because stroke volume (SV) may also vary with the changes in ventricular filling time (17,34,48). Furthermore, transient increases in CO will lower ventricular filling pressure (and decreases in CO will raise filling pressure), thereby providing a self-limiting response (6,30,40). Furthermore, baroreflex control of HR may not functionally buffer high-frequency (Hi-F: above 0.15 Hz) blood pressure fluctuations (4,38,44). In this case, Hi-F variations of CO could facilitate blood pressure variability via a feedforward mechanism rather than buffer arterial pressure. In addition, it has been shown that in anesthetized rats, the blood pressure response to cardiac pacing induced high-frequency oscillation of CO is smaller than that to low-frequency oscillation of CO (41). To our knowledge, however, the dynam...

show abstract

“…Mechanical ventilation, frequently with high levels of positive end-expiratory pressure (PEEP), can increase intrathoracic pressure and result in decreased venous return [20] . Reduced preload in the return could result in decreased cardiac output and hypotension.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcomes in patients with ICU-related pancreatitis

Tseng

Fang²,

Chung³

et al. 2009

WJG

View full text Add to dashboard Cite

AIM:To identify risk factors predictive of intensive care unit (ICU) mortality in patients with ventilatorrelated pancreatitis. The clinical outcomes of patients with ventilator-related pancreatitis were compared with those of patients with pancreatitis-related respiratory failure as well as controls. METHODS:One hundred and forty-eight patients with respiratory failure requiring mechanical ventilation and concomitant acute pancreatitis were identified from a prospectively collected dataset of 9108 consecutive patients admitted with respiratory failure over a period of five years. Sixty patients met the criteria for ventilator-related pancreatitis, and 88 (control patients), for pancreatitis-related respiratory failure. RESULTS:Mortality rate in ventilator-related pancreatitis was comparable to that in ICU patients without pancreatitis by case-control methodology (P = 0.544). Multivariate logistic regression analysis identified low PaO2/FiO2 (OR: 1.032, 95% CI: 1.006-1.059, P = 0.016) as an independent risk factor for mortality in patients with ventilator-related pancreatitis. The mortality rate in patients with ventilator-related pancreatitis was lower than that in patients with acute pancreatitis-related respiratory failure (P < 0.001). CONCLUSION:We found that low PaO2/FiO2 was an independent clinical parameter predictive of ICU mortality in patients with ventilator-related pancreatitis.

show abstract

Hemodynamic Consequences of Heart-Lung Interactions

Cited by 47 publications

References 24 publications

Physiological changes during low- and high-intensity noninvasive ventilation

Physiological changes during low- and high-intensity noninvasive ventilation

Dynamic cardiac output regulation at rest, during exercise, and muscle metaboreflex activation: impact of congestive heart failure

Clinical outcomes in patients with ICU-related pancreatitis

Contact Info

Product

Resources

About