Hemodynamic effects of synchronous high-frequency jet ventilation during acute hypovolemia

Matuschak, GM and Pinsky, MR and Klain, M (1986) Hemodynamic effects of synchronous high-frequency jet ventilation during acute hypovolemia. Journal of Applied Physiology, 61 (1). 44 - 53. ISSN 8750-7587

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Abstract

We studied the effects of synchronous cardiac cycle-specific high-frequency jet ventilation (HFJV) in pentobarbitol-anesthetized, splenectomized, closed-chest dogs to test the hypothesis that phasic inspiratory increases in intrathoracic pressure (ITP) selectively timed to specific periods of the cardiac cycle have different hemodynamic effects during both hypovolemia (acute hemorrhage, 20 ml/kg) and neurogenic vasomotor shock (hexamethonium, 10 mg/kg) than those observed during normovolemic control conditions. Ventricular stroke volumes (SV) were measured by electromagnetic flow probes. The influence of changes in venous return (VR) on the subsequent hemodynamic response to synchronous HFJV was analyzed using instantaneous VR curves (M.R. Pinsky, J. Appl. Physiol. 56:765-771, 1984). During hemorrhage the VR curve was shifted leftward with concomitant reductions in apneic SV (15.4 ± 3.8 to 11.2 ± 3.6 ml, mean ± SD), P < 0.01) that were accentuated by HFJV (P < 0.01), except when the phasic inspiratory increases in ITP during HFJV were timed to occur during late diastole (-4% apneic SV, NS). SV was greater with late diastolic pulses than with other timed synchronous ITP pulses during hypovolemia (P < 0.01). During ganglionic blockade, arterial pressure decreased (139 ± 14 to 76 ± 18 Torr, P < 0.001), but VR was preserved at control levels, and no significant cardiac cycle-specific HFJV effects occurred. We conclude that SV reductions associated with positive-pressure ventilation during acute hypovolemia are minimized by HFJV synchronized to late diastole but that this effect is preload dependent.

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Details

Item Type:	Article
Status:	Published
Creators/Authors:	Creators Email Pitt Username ORCID Matuschak, GM Pinsky, MR pinsky@pitt.edu PINSKY Klain, M
Date:	1 January 1986
Date Type:	Publication
Journal or Publication Title:	Journal of Applied Physiology
Volume:	61
Number:	1
Page Range:	44 - 53
Schools and Programs:	School of Medicine > Critical Care Medicine
Refereed:	Yes
ISSN:	8750-7587
Date Deposited:	24 Feb 2012 16:05
Last Modified:	04 Feb 2019 15:56
URI:	http://d-scholarship.pitt.edu/id/eprint/11021

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