Positive Pressure Ventilation Reduces Right Ventricular Stroke Volume via Alterations in Both Preload and Afterload

CHEST Journal ◽  
2013 ◽  
Vol 144 (4) ◽  
pp. 881A
Author(s):  
Jeremy Wrobel ◽  
Bruce Thompson ◽  
Christopher Stuart-Andrews ◽  
Kirk Kee ◽  
Gregory Snell ◽  
...  
1986 ◽  
Vol 61 (3) ◽  
pp. 819-826 ◽  
Author(s):  
R. J. Henning

Transmural cardiac pressures, stroke volume, right ventricular volume, and lung water content were measured in normal dogs and in dogs with oleic acid-induced pulmonary edema (PE) maintained on positive-pressure ventilation. Measurements were performed prior to and following application of 20 cmH2O positive end-expiratory pressure (PEEP). Colloid fluid was given during PEEP for ventricular volume expansion before and after the oleic acid administration. PEEP significantly increased pleural pressure and pulmonary vascular resistance but decreased right ventricular volume, stroke volume, and mean arterial pressure in both normal and PE dogs. Although the fluid infusion during PEEP raised right ventricular diastolic volumes to the pre-PEEP level, the stroke volumes did not significantly increase in either normal dogs or the PE dogs. The fluid infusion, however, significantly increased the lung water content in the PE dogs. Following discontinuation of PEEP, mean arterial pressure, cardiac output, and stroke volume significantly increased, and heart rate did not change. The failure of the stroke volume to increase despite significant right ventricular volume augmentation during PEEP indicates that positive-pressure ventilation with 20 cmH2O PEEP decreases right ventricular function.


1991 ◽  
Vol 261 (3) ◽  
pp. H751-H754 ◽  
Author(s):  
P. Mols ◽  
C. H. Huynh ◽  
N. Naeije ◽  
H. R. Ham

Right ventricular (RV) adaptation to supine exercise has been studied in 10 young male volunteers by 81mKr electrocardiogram (ECG)-gated radionuclide ventriculography. During progressive supine exercise, the ejection fraction gradually increased from a mean value of 46% at rest up to 60% at a maximal exercise level. End-diastolic volume however remained unchanged at a low exercise level and even slightly decreased at a higher exercise level. Little or no change in end-diastolic volume and an increase in ejection fraction produced a significant decrease in end-systolic volume and a net increase in stroke volume. These results indicate that the Frank-Starling mechanism does not contribute to the increase in right ventricular stroke volume during progressive supine exercise, but the increase in right ventricular stroke volume rather seems related to an increased contractility, presumably mediated by an increased sympathetic activity.


2005 ◽  
Vol 96 (8) ◽  
pp. 1173-1178 ◽  
Author(s):  
Stig Urheim ◽  
Sanderson Cauduro ◽  
Robert Frantz ◽  
Michael McGoon ◽  
Marek Belohlavek ◽  
...  

2015 ◽  
Vol 36 (5) ◽  
pp. 925-937 ◽  
Author(s):  
Mads Dam Vildbrad ◽  
Asger Andersen ◽  
Thomas Krarup Andersen ◽  
Sofie Axelgaard ◽  
Sarah Holmboe ◽  
...  

2020 ◽  
Vol 8 (1) ◽  
Author(s):  
David Berger ◽  
Jan Hobi ◽  
Per W. Möller ◽  
Matthias Haenggi ◽  
Jukka Takala ◽  
...  

Abstract Background Stroke volume measurement should provide estimates of acute treatment responses. The current pulse contour method estimates left ventricle stroke volume. Heart-lung interactions change right ventricular stroke volume acutely. We investigated the accuracy, precision, and trending abilities of four calibrated stroke volume estimates based on pulmonary artery pulse contour analysis. Results Stroke volume was measured in 9 pigs with a pulmonary artery ultrasound flow probe at 5 and 10 cmH2O of PEEP and three volume states (baseline, bleeding, and retransfusion) and compared against stroke volume estimates of four calibrated pulmonary pulse contour algorithms based on pulse pressure or pressure integration. Bland-Altman comparison with correction for multiple measurements and trend analysis were performed. Heart rate and stroke volumes were 104 ± 24 bpm and 30 ± 12 mL, respectively. The stroke volume estimates had a minimal bias: − 0.11 mL (95% CI − 0.55 to 0.33) to 0.32 mL (95% CI − 0.06 to 0.70). The limits of agreement were − 8.0 to 7.8 mL for calibrated pulse pressure to − 10.4 to 11.5 mL for time corrected pressure integration, resulting in a percentage error of 36 to 37%. The calibrated pulse pressure method performed best. Changes in stroke volume were trended very well (concordance rates 73–100%, r2 0.26 to 0.987, for pulse pressure methods and 71–100%, r2 0.236 to 0.977, for integration methods). Conclusions Pulmonary artery pulse contour methods reliably detect acute changes in stroke volume with good accuracy and moderate precision and accurately trend short-term changes in cardiac output over time.


Sign in / Sign up

Export Citation Format

Share Document