Effects of spontaneous ventilation on the circulation

Robert A Wise, J. L. Robotham, W. R. Summer

Research output: Contribution to journalArticle

Abstract

Spontaneous inspiration causes an increase in right ventricular stroke volume due to a transient increase in venous return. In contrast, spontaneous inspiration causes a fall in left ventricular stroke volume which is exaggerated in conditions of accentuated pleural pressure swings and pericardial disease. This is manifested by the clinical sign of pulsus paradoxus. Recent evidence supports the idea that pulsus paradoxus is the result of two mechanisms. First, negative pleural pressure surrounding the left ventricle is equivalent to an increase in aortic pressure and impedes emptying of the left ventricle much like an increase in afterload. Second, distention of the right ventricle due to the transient increase in venous return causes an elevation of left ventricular diastolic pressure due to ventricular interdependence and therefore impedes left ventricular filling. The mechanism of negative pleural pressure "afterload" is thought to be the major cause of pulsus paradoxus when pleural pressure swings are accentuated. Ventricular interdependence is thought to predominate when pericardial disease is present.

Original languageEnglish (US)
Pages (from-to)175-186
Number of pages12
JournalLung
Volume159
Issue number1
DOIs
StatePublished - Dec 1981

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Ventilation
Heart Ventricles
Pulse
Pressure
Stroke Volume
Ventricular Pressure
Arterial Pressure
Blood Pressure

Keywords

  • Pulsus paradoxus
  • Ventilation and circulation

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Physiology

Cite this

Effects of spontaneous ventilation on the circulation. / Wise, Robert A; Robotham, J. L.; Summer, W. R.

In: Lung, Vol. 159, No. 1, 12.1981, p. 175-186.

Research output: Contribution to journalArticle

Wise, RA, Robotham, JL & Summer, WR 1981, 'Effects of spontaneous ventilation on the circulation', Lung, vol. 159, no. 1, pp. 175-186. https://doi.org/10.1007/BF02713914
Wise, Robert A ; Robotham, J. L. ; Summer, W. R. / Effects of spontaneous ventilation on the circulation. In: Lung. 1981 ; Vol. 159, No. 1. pp. 175-186.
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