PT  - JOURNAL ARTICLE
AU  - HE Fessler
TI  - Heart-lung interactions: applications in the critically ill
AID  - 10.1183/09031936.97.10010226
DP  - 1997 Jan 01
TA  - European Respiratory Journal
PG  - 226--237
VI  - 10
IP  - 1
4099  - http://erj.ersjournals.com/content/10/1/226.short
4100  - http://erj.ersjournals.com/content/10/1/226.full
SO  - Eur Respir J1997 Jan 01; 10
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.