RT Journal Article
SR Electronic
T1 Heart-lung interactions: applications in the critically ill
JF European Respiratory Journal
JO Eur Respir J
FD European Respiratory Society
SP 226
OP 237
DO 10.1183/09031936.97.10010226
VO 10
IS 1
A1 HE Fessler
YR 1997
UL http://erj.ersjournals.com/content/10/1/226.abstract
AB Since the circulatory and pulmonary systems are both driven by pressure and share space in the thorax, it is inevitable that they interact. These mechanical interactions, whilst relatively few in number, are protean in their manifestations. The circulatory system of the critically ill is often particularly susceptible to interference from respiration. Compensatory reserve is limited, ventilatory effort increased, and many critical care respiratory interventions place strain on the circulation, not seen in health. This review will examine the basic physiological mechanisms through which the pulmonary and circulatory systems interact. These mechanisms will then be applied to a variety of weaning, positive end-expiratory pressure (PEEP), and cardiopulmonary resuscitation techniques. It is hoped that this will provide the tools to understand clinical observations which would otherwise appear inexplicable.