Respiratory Therapy in Patients with Heart Failure

  • P. Nikki
  • J. Räsänen
  • I. Väisänen
Conference paper
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 1)


This paper discusses the respiratory therapy in patients with acute respiratory failure due to acute myocardial infarction (AMI). Several events in the course of AMI may lead to respiratory failure requiring ventilatory support. Since the lungs and the heart form a functional unit, therapy directed at one frequently affects the other. Particularly during the initial hours of AMI, deranged hemodynamics and various therapeutic interventions markedly influence ischemic myocardial segments and final infarct size [13].


Acute Myocardial Infarction Continuous Positive Airway Pressure Acute Myocardial Infarction Acute Respiratory Failure Spontaneous Breathing 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Aubier M, Trippenbach T, Roussos C (1981) Respiratory muscle fatigue during cardiogenic shock. J Appl Physiol 51: 499–508PubMedGoogle Scholar
  2. 2.
    Barach AL, Martin J, Eckman M (1938) Positive pressure respiration and its application to the treatment of acute pulmonary edema Ann Intern Med 12: 754–795Google Scholar
  3. 3.
    Breivik H, Grenvik A, Millen E, Safar P (1973) Normalizing low arterial CO2 tension during mechanical ventilation Chest 63: 525–531Google Scholar
  4. 4.
    Downs JB, Douglas ME (1982) Applied physiology and respiratory care. In: Shoemaker WC, Thompson WL (eds.) Critical care: state of the art, vol 3. Fullerton CA: Society of Critical Care Medicine 1–35Google Scholar
  5. 5.
    Gherini S, Peters RM, Virgilio RW (1979) Mechanical work on the lungs and work of breathing with positive end-expiratory pressure and continuous positive airway pressure. Chest 76: 251–256PubMedCrossRefGoogle Scholar
  6. 6.
    Laver MB, Strauss WH, Pohost GM (1979) Right and lelft ventricular geometry: adjustments during acute respiratory failure. Crit Care med 7: 509–519PubMedCrossRefGoogle Scholar
  7. 7.
    Mason DT, Spann JF Jr, Zells R, Amsterdam EA (1970) Alterations of hemodynamics and myocardial mechanics in patients with congestive heart failure. Prog. Cardiovasc Dis 12: 507–557Google Scholar
  8. 8.
    Mathru M, Rao TLK, El-Etr AA, Pifarre R (1982) Hemodynamic response to changes in ventilatory patterns in patients with normal and poor left ventricular reserve. Crit Care Med 10: 423–426PubMedCrossRefGoogle Scholar
  9. 9.
    Nikki P, Räsänen J, Tahvanainen J, Mäkeläinen A (1982) Ventilatory pattern in respiratory failure arising from acute myocardial infarction: I Respiratory and hemodynamic effects of IMV 4 vs IPPV 12 and PEEP 0 vs PEEP 10. Crit Care Med 10: 75–78PubMedCrossRefGoogle Scholar
  10. 10.
    Pere] A, Williamson DC, Modell JH (1983) Effectiveness of CPAP by mask for pulmonary edema associated with hypercarbia. Intensive Care Med 9: 17–19CrossRefGoogle Scholar
  11. 11.
    Pinsky MR, Summer WR (1983) Cardiac augmentation by phasic high intrathoracic pressure support in man. Chest 84: 370–375PubMedCrossRefGoogle Scholar
  12. 12.
    Robotham JL, Bell RC, Badke FR, Kindred MK (1985) Left ventricular geometry during positive end-expiratory pressure in dogs. Crit Care Med 13: 617–624PubMedCrossRefGoogle Scholar
  13. 13.
    Rude RE, Muller JE, Braunwald E (1981) Efforts to limit the size of myocardial infarcts. Ann Intern Med 95: 736–761PubMedGoogle Scholar
  14. 14.
    Räsänen J (1985) Conventional and high frequency controlled mechanical ventilatory support in patients with left ventricular dysfunction and pulmonary edema. Submitted for publicationGoogle Scholar
  15. 15.
    Räsänen J, Heikkilä J, Downs J, Nikki P, Väisänen I, Viitanen A (1985) Continuous positive airiway pressure by face mask in acute cardiogenic pulmonary edema. Am J Cardiol 55: 296–300PubMedCrossRefGoogle Scholar
  16. 16.
    Räsänen J, Nikki P, Heikkilä J (1984) Acute myocardial infarction complicated by respiratory failure. The effects of mechanical ventilation. Chest 85: 21–28Google Scholar
  17. 17.
    Räsänen J, Väisänen I, Heikkilä J, Nikki P (1985) Acute myocardial infarction complicated by left ventricular dysfunction and respiratory failure. The effects of continuous positive airway pressure. Chest 87: 158–162Google Scholar
  18. 18.
    Sturgeon CL Jr, Douglas ME, Downs JB, Dannemiller FJ (1977) PEEP and CPAP: cardiopulmonary effects during spontaneous ventilation Anesth Analg 56: 633–641Google Scholar
  19. 19.
    Valencia A, Burgess JH (1969) Arterial hypoxemia following acute myocardial infarction, Circulation 40: 641–656PubMedCrossRefGoogle Scholar
  20. 20.
    Weisman IM, Rinaldo JE, Rogers RM (1982) Positive end-expiratory pressure in adult respiratory failure. N Engl J Med 307: 1381–1384PubMedCrossRefGoogle Scholar
  21. 21.
    West JB (1975) New advances in pulmonary gas exchange. Anesth Analg 54: 409–418PubMedGoogle Scholar
  22. 22.
    Vuori A (1981) Central hemodynamics, oxygen transport and oxygen consumption during three methods for CPAP. Acta Anaesth Scand 25: 376–380.PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1986

Authors and Affiliations

  • P. Nikki
  • J. Räsänen
  • I. Väisänen

There are no affiliations available

Personalised recommendations