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Left ventricular function during respiratory failure

D L Rice, D J Kearney, R J Awe

    Critical Care Medicine
    |July 1, 1977
    PubMed
    Summary
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    Treating chronic obstructive pulmonary disease (COPD) in patients with respiratory failure improved left ventricular function. This suggests cardiac function is linked to lung disease severity and improves with COPD therapy.

    Area of Science:

    • Cardiology
    • Pulmonology
    • Critical Care Medicine

    Background:

    • Chronic obstructive pulmonary disease (COPD) can lead to respiratory failure.
    • Respiratory failure may adversely affect left ventricular (LV) function.
    • The relationship between pulmonary disease treatment and cardiac function requires further investigation.

    Purpose of the Study:

    • To investigate the impact of treating respiratory failure in COPD patients on LV function.
    • To determine if LV function improves with pulmonary disease management.
    • To explore the link between cardiac performance and COPD exacerbations.

    Main Methods:

    • Studied seven patients with COPD in acute respiratory failure (PaCO2 > 49 torr).
    • Assessed indirect LV function measures: pulmonary capillary wedge pressure (PCWP), systolic time intervals (STI), and cardiac output.

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  • Utilized Swan-Ganz catheter for hemodynamic monitoring.

    • Main Results:

    • Treatment of respiratory failure led to significant improvements in LV function.
    • Observed decreased PCWP and pre-ejection period/left ventricular ejection time (PEP/LVET) ratio.
    • Noted an increase in dp/dt/pulmonary capillary wedge pressure (PCWP) post-treatment.

    Conclusions:

    • Respiratory failure in COPD patients is associated with depressed LV function.
    • Therapeutic interventions for COPD can ameliorate cardiac dysfunction.
    • LV function improvement occurred without cardiac-specific medications, highlighting the pulmonary-cardiac link.