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Table of contents

  1. Front Matter
    Pages I-XI
  2. D. Scheidegger
    Pages 61-71
  3. P. Foëx
    Pages 72-80
  4. J. F. Dhainaut, F. Brunet, D. Villemant
    Pages 95-106
  5. J. Peters, J. L. Robotham
    Pages 120-134
  6. D. M. Payen, S. Beloucif
    Pages 135-145
  7. H. H. Steinhoff, J. Bergmann, K. J. Falke
    Pages 146-155
  8. P. M. Suter
    Pages 156-164
  9. G. Crimi, M. Bufi, G. Conti
    Pages 174-182
  10. J. Räsänen, P. Nikki, I. T. Väisänen
    Pages 183-191
  11. A. Artigas, A. Roglan, R. Martinez
    Pages 203-225
  12. R. D. Weisel, T. A. Salerno
    Pages 256-265

About this book

Introduction

In summary, the mechanical integration of ventricular and pulmonary actions is determined by a number of mechanisms including airway pressure, pleural and pericardial pressure, state of the interventricular septum, and others. After this brief review of essential features, we may discuss some aspects of the interactions between heart and lung function. Influence of Intrathoracic Pressure: The Importance of Transmural Pressure It is established that blood pressure, volume and flow rates in the lesser circula­ tion change during each respiratory cycle. The effects of intrathoracic (Pit) and pleural (P pi) pressures, and lung volumes, were recently described in terms of ventricular preload and afterload during normal breathing, hyperventilation, and the Valsalva and Muller maneuvers [4, 7, 8]. Still, many aspects remain unsettled, mainly because of technical difficulties related to the simultaneous recording of floating respiratory and circulatory events in the intact animal or in man [9]. Some confusion arises from the clinicians' unawareness of the role played by the transmural pressure (Ptm), being the pressure gradient between the lumen of a vessel or heart chamber and the surrounding tissues (Pit for the pulmonary arteries and veins, and Ppe for the heart). Yet, an undetected change of Plm may modify vascular caliber and resistance in the pulmonary district, regardless of any changes in vasomotor activity. Consequently, a change of vascular resistance concomitant with a change of Ptm is not a reliable index of pulmonary vasomo­ tricity.

Keywords

Acute respiratory distress syndrome (ARDS) arteries blood blood pressure breathing heart lung lung function mechanical ventilation pulmonary embolism resistance respiratory failure tissue ventilation

Editors and affiliations

  • Jean Louis Vincent
    • 1
  • Peter M. Suter
    • 2
  1. 1.Department of Intensive Care, Erasme HospitalFree University of BrusselsBrusselsBelgium
  2. 2.Department of Surgical Intensive CareUniversity Hospital of GenevaGeneva 4Switzerland

Bibliographic information

  • DOI https://doi.org/10.1007/978-3-642-83010-5
  • Copyright Information Springer-Verlag Berlin Heidelberg 1987
  • Publisher Name Springer, Berlin, Heidelberg
  • eBook Packages Springer Book Archive
  • Print ISBN 978-3-540-17474-5
  • Online ISBN 978-3-642-83010-5
  • Series Print ISSN 0933-6788
  • Buy this book on publisher's site
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