Respiratory pump maintains cardiac stroke volume during hypovolemia in young, healthy volunteers

Journal of Applied Physiology
Maria SkytiotiMaja Elstad

Abstract

Spontaneous breathing has beneficial effects on the circulation, since negative intrathoracic pressure enhances venous return and increases cardiac stroke volume. We quantified the contribution of the respiratory pump to preserve stroke volume during hypovolemia in awake, young, healthy subjects. Noninvasive stroke volume, cardiac output, heart rate, and mean arterial pressure (Finometer) were recorded in 31 volunteers (19 women), 19-30 yr old, during normovolemia and hypovolemia (approximating 450- to 500-ml reduction in central blood volume) induced by lower-body negative pressure. Control-mode noninvasive positive-pressure ventilation was employed to reduce the effect of the respiratory pump. The ventilator settings were matched to each subject's spontaneous respiratory pattern. Stroke volume estimates during positive-pressure ventilation and spontaneous breathing were compared with Wilcoxon matched-pairs signed-rank test. Values are overall medians. During normovolemia, positive-pressure ventilation did not affect stroke volume or cardiac output. Hypovolemia resulted in an 18% decrease in stroke volume and a 9% decrease in cardiac output ( P < 0.001). Employing positive-pressure ventilation during hypovolemia decreased stro...Continue Reading

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Citations

May 30, 2020·Anesthesiology·Bryan A Davis, Lawrence C Tsen
Jun 22, 2019·Journal of Applied Physiology·Victor A Convertino
Feb 19, 2021·Journal of Cardiothoracic and Vascular Anesthesia·Jon-Émile S Kenny
Dec 29, 2020·Anesthesiology·Bryan A Davis, Lawrence C Tsen
Aug 18, 2021·Journal of the American College of Emergency Physicians Open·Jon-Émile S KennyBruce D Johnson
Aug 26, 2020·British Journal of Anaesthesia·Ulrich Limper

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Methods Mentioned

BETA
sedation

Software Mentioned

StatXact
Cytel Studio
Modelflow
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