TY - JOUR
T1 - Interactions between respiration and systemic hemodynamics. Part II
T2 - Practical implications in critical care
AU - Feihl, François
AU - Broccard, Alain F.
PY - 2009/2
Y1 - 2009/2
N2 - In Part I of this review, we have covered basic concepts regarding cardiorespiratory interactions. Here, we put this theoretical framework to practical use. We describe mechanisms underlying Kussmaul's sign and pulsus paradoxus. We review the literature on the use of respiratory variations of blood pressure to evaluate volume status. We show the possibilities of attaining the latter aim by investigating with ultrasonography how the geometry of great veins fluctuates with respiration. We provide a Guytonian analysis of the effects of PEEP on cardiac output. We terminate with some remarks on the potential of positive pressure breathing to induce acute cor pulmonale, and on the cardiovascular mechanisms that at times may underly the failure to wean a patient from the ventilator.
AB - In Part I of this review, we have covered basic concepts regarding cardiorespiratory interactions. Here, we put this theoretical framework to practical use. We describe mechanisms underlying Kussmaul's sign and pulsus paradoxus. We review the literature on the use of respiratory variations of blood pressure to evaluate volume status. We show the possibilities of attaining the latter aim by investigating with ultrasonography how the geometry of great veins fluctuates with respiration. We provide a Guytonian analysis of the effects of PEEP on cardiac output. We terminate with some remarks on the potential of positive pressure breathing to induce acute cor pulmonale, and on the cardiovascular mechanisms that at times may underly the failure to wean a patient from the ventilator.
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U2 - 10.1007/s00134-008-1298-y
DO - 10.1007/s00134-008-1298-y
M3 - Review article
C2 - 18825366
AN - SCOPUS:59849084096
SN - 0342-4642
VL - 35
SP - 198
EP - 205
JO - Intensive Care Medicine
JF - Intensive Care Medicine
IS - 2
ER -