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Hemodynamic effects of ventilation and ventilatory maneuvers

Pinsky, MR (2001) Hemodynamic effects of ventilation and ventilatory maneuvers. In: Respiratory-Circulatory Interactions in Health and Disease. UNSPECIFIED, 183 - 218. ISBN 9780824704742

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Abstract

© 2001 by Taylor & Francis Group, LLC. The cardiocirculatory-respiratory system is a complex and highly integrated system that balances the ever changing and often conflicting metabolic demands of the body in a smooth fashion over a remarkably wide range of metabolic demands and constraints that life creates. The system includes such varied functional structures as the left and right atria (LA and RA, respectively) and ventricles (LV and RV, respectively) and the pulmonary and systemic vasculature. It works in an environment of differential extravascular pressures that reflect the tissue surface pressures of the major body compartments, thorax, abdomen, cranium, and muscular tissue spaces. The system’s response to the varying demands and field conditions are profoundly influenced by myocardial reserve, vascular resistance, circulating blood volume, blood flow distribution, autonomic tone, and endocrinological processes, as well as by baseline lung volume and its change, intrathoracic pressure (ITP), and the surrounding pressures for the remainder of the circulation, as induced by the mechanical and spontaneous breath. It should not be surprising, therefore, that dramatically different hemodynamic responses to similar ventilatory maneuvers can occur among subjects. These concepts have been previously described by our group (1-13) and others (14-18). The reader is referred to these prior reviews for greater in-depth discussions of the specific physiologic details discussed below. This chapter will focus primarily on the clinical application of these principals in common condi- 184 Pinsky tions and as a physiological paradigm for the reader to understand better the subsequent chapters in Section IV for specific disease states.


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Details

Item Type: Book Section
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Pinsky, MRpinsky@pitt.eduPINSKY
Date: 1 January 2001
Date Type: Publication
Access Restriction: No restriction; Release the ETD for access worldwide immediately.
Page Range: 183 - 218
Institution: University of Pittsburgh
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISBN: 9780824704742
Title of Book: Respiratory-Circulatory Interactions in Health and Disease
Date Deposited: 14 Jul 2012 14:31
Last Modified: 31 Jan 2019 18:55
URI: http://d-scholarship.pitt.edu/id/eprint/12182

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