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Lung volume and pleural pressure effects on ventricular function

B H Culver, J J Marini, J Butler

    Journal of Applied Physiology: Respiratory, Environmental and Exercise Physiology
    |March 1, 1981
    PubMed
    Summary
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    Continuous positive-pressure ventilation alters ventricular function primarily due to increased lung volume. This lung distension, not increased afterload, affects both right and left ventricular hemodynamics during mechanical ventilation.

    Area of Science:

    • Cardiology
    • Pulmonary Medicine
    • Physiology

    Background:

    • Mechanical ventilation, particularly continuous positive-pressure ventilation (CPPV), can impact cardiac function.
    • Understanding the specific mechanisms behind these cardiac changes is crucial for patient management.

    Purpose of the Study:

    • To elucidate the effects of increased lung volume, pleural pressure, and right ventricular afterload on ventricular function during CPPV.

    Main Methods:

    • Hemodynamic parameters were measured in 15 dogs under controlled conditions.
    • The study isolated the effects of increasing lung volume, pleural pressure, and pulmonary artery constriction.

    Main Results:

    • Increased lung volume during ventilation led to elevated atrial pressures and reduced cardiac output.

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  • Changes observed with lung distension were distinct from those caused by isolated increases in pleural pressure or right ventricular afterload.

    • Conclusions:

    • The observed alterations in ventricular function during CPPV are primarily attributed to the increase in lung volume.
    • Ventricular interdependence due to increased right ventricular afterload is not the main mechanism responsible for CPPV-induced hemodynamic changes.