Skip to main content

Right Ventricular Performance in the Adult Respiratory Distress Syndrome

  • Chapter
Cardiopulmonary Interactions in Acute Respiratory Failure

Part of the book series: Update in Intensive Care and Emergency Medicine ((UICM,volume 2))

Abstract

The Adult Respiratory Distress Syndrome (ARDS) is a catastrophic form of acute hypoxemic respiratory failure which usually follows a variety of direct and indirect insults to the lung’s gas-exchanging membrane (Table 1). The major pulmonary manifestations of ARDS include:

  • permeability pulmonary edema (PPE);

  • decreased pulmonary compliance; and,

  • pulmonary hypertension (PH).

ARDS is also frequently associated with evidence which defines a concurrent injury to the peripheral microcirculation insofar that the efficiency of peripheral oxygen extraction may be reduced in the presence of a demonstrable oxygen need [1, 2].

This is a preview of subscription content, log in via an institution to check access.

Access this chapter

Institutional subscriptions

Preview

Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.

References

  1. Danek SJ, Lynch JP, Weg JD et al (1980) The dependence of oxygen uptake on oxygen delivery in the adult respiratory distress syndrome. Am Rev Respir Dis 122:387–392

    PubMed  CAS  Google Scholar 

  2. Cain SM (1984) Supply dependency of oxygen uptake in ARDS: Myth or reality? Am J Med Sei 288:119–124

    Article  CAS  Google Scholar 

  3. Montgomery AB, Stager MA, Carrico CJ, Hudson DL (1985) Causes of mortality in patients with the adult respiratory distress syndrome. Am Rev Respir Dis 132:485–489

    PubMed  CAS  Google Scholar 

  4. Zapol W, Snider MT (1977) Pulmonary hypertension in severe acute respiratory failure. N Engl J Med 296:476–480

    Article  PubMed  CAS  Google Scholar 

  5. Sibbald WJ, Paterson NAM, Holliday RL, Anderson RR, Lobb TR, Duff JH (1978) Pulmonary hypertension in sepsis. Chest 73:583–591

    Article  PubMed  CAS  Google Scholar 

  6. Barnard GR, Rinaldo J, Horns T, Kariman K, Sibbald W, Bradley R et al (1985) Early predictors of ARDS reversal in patients with established ARDS. Am Rev Respir Dis 131:143 (Abstract)

    Google Scholar 

  7. Shoemaker WC (1985) Controversies in the pathophysiology and fluid management of postoperative adult respiratory distress syndrome. Surg Clin North Am 65:931

    PubMed  CAS  Google Scholar 

  8. Gnidec A, MacDonald J, Craig I, Finely R, Sibbald W (1984) The effect of aspirin in acute microvascular lung injury (AMI) induced by ZAP. Am Rev Respir Dis 129(4): Part 2:A105 (Abstract)

    Google Scholar 

  9. Pine RW, Wertz MJ, Lennards M et al (1983) Determinants of organ malfunction or death in patients with intra-abdominal sepsis. Arch Surg 118:242

    Article  PubMed  CAS  Google Scholar 

  10. Kaul S, Hopkins JM, Shah PM (1983) Chronic effects of myocardial infarction on right ventricular function: A non-invasive assessment. JACC 2:607–615

    PubMed  CAS  Google Scholar 

  11. Stein PO, Sabbath HN, Anbe DT, Marzilli M (1979) Performance of the failing and non- failing right ventricle of patients with coronary heart disease: A new approach using equilibrium radionuclide angiography. Am J Cardiol 44:1050–1055

    Article  PubMed  CAS  Google Scholar 

  12. Iskandrian AS, Hakki AH, Ren JF et al (1984) Correlation among right ventricular preload, afterload and ejection fraction in mitral valve disease: radionuclide, echocardiographic and hemodynamic evaluation. JACC 3:1403–1411

    PubMed  CAS  Google Scholar 

  13. Brent BN, Berger HJ, Matthay RA, Mahler D, Pytlik L, Zaret BL (1982) Physiologic correlates of right ventricular ejection fraction in chronic obstructive lung disease: A combined radionuclide and hemodynamic study. Am J Cardiol 50:255–262

    Article  PubMed  CAS  Google Scholar 

  14. Matthay RA, Ellis JH, Steele PP (1978) Methoxamine-induced increase in afterload: effect on left ventricular performance in chronic obstructive lung disease. Am Rev Respir Dis 117:871–877

    PubMed  CAS  Google Scholar 

  15. Weber KT, Janicki JS, Shroff S, Fishman AP (1981) Contractile mechanics and interaction of the right and left ventricles. Am J Cardiol 47:686–695

    Article  PubMed  CAS  Google Scholar 

  16. Matthay RA, Berger HJ, Loke J et al (1978) Effects of aminophylline upon right and left ventricular performance in chronic obstructive pulmonary disease: non-invasive assessment by radionuclide angiocardiography. Am J Med 65:903–910

    Article  PubMed  CAS  Google Scholar 

  17. Ross J Jr, Braunwald E (1964) Study of left ventricular function in man by increasing resistance to ventricular ejection with angiotension. Circulation 29:737–749

    Google Scholar 

  18. Maughan WL, Shoukas AA, Sagawa K, Weisfeldt ML (1979) Instantaneous pressure-volume relationship of the canine right ventricle. Circ Res 44:309–315

    PubMed  CAS  Google Scholar 

  19. Sagawa K (1978) The ventricular pressure-volume diagram revisited. Circ Res 43:677–687

    PubMed  CAS  Google Scholar 

  20. Sharma GV, Mclntyre KM, Sharma S, Sasahara AA (1984) Clinical and hemodynamic correlates in pulmonary embolism. Clin Chest Med 5:421–437

    PubMed  CAS  Google Scholar 

  21. Winn R, Harlan J, Madir B, Harker J, Hildebrandt J (1983) Thromboxane A2 mediates lung vasoconstriction but not permeability after endotoxin. J Clin Invest 72:911–918

    Article  PubMed  CAS  Google Scholar 

  22. Sharkey P, Judges D, Driedger A, Cheung H, Finley R, Sibbald W (1984) The effect of an infusion of zymosan-activated plasma on hemodynamic and pulmonary function in sheep. Circ Shock 12:79–83

    PubMed  CAS  Google Scholar 

  23. Leeman M, Boeynaems JM, Degaute JP, Vincent JL, Kahn RJ (1985) Administration of dazoxiben, a selective thromboxane synthetase inhibitor in the adult respiratory distress syndrome. Chest 87:726–730

    Article  PubMed  CAS  Google Scholar 

  24. Renes HD, Halushaki PV, Olanoff LS, Hunt PS (1985) Dazoxiben in human sepsis and adult respiratory distress syndrome. Clin Pharm Ther 37:391–395

    Article  Google Scholar 

  25. Sibbald WJ, Peters S, Lindsay RM (1980) Serotonin and pulmonary hypertension in human septic ARDS. Crit Care Med 8(9): 490–494

    Article  PubMed  CAS  Google Scholar 

  26. Haljamae H (1985) Pathophysiology of shock-induced disturbances in tissue homeostasis. Acta Anaesthesiol Scand 29:38–44

    Article  Google Scholar 

  27. Tomashefski JF, Davies P, Boggis C, Greene R, Zapol W, Reid LM (1983) The pulmonary vascular lesions of the adult respiratory distress syndrome. Am J Pathol 112:112–126

    PubMed  Google Scholar 

  28. Sibbald WJ, Driedger AA (1983) Right ventricular function in acute disease states: Pathophysiologic considerations. Crit Care Med 11 (5): 339–345

    Article  PubMed  CAS  Google Scholar 

  29. Raper R, Sibbald WJ, Driedger A A, Gerow K: Sepsis, without antecedent shock, is associated with “relative” myocardial contractile depression. N Engl J Med (Submitted)

    Google Scholar 

  30. Martyn JAJ, Snider MT, Szyfelbein SK, Burke JF, Laver MB (1980) Right ventricular dysfunction in acute thermal injury. Ann Surg 191:330–335

    Article  PubMed  CAS  Google Scholar 

  31. Vlahakes GJ, Turley K, Hoffman JI (1981) The pathophysiology of failure in acute right ventricular hypertension: Hemodynamic and biochemical considerations. Circulation 63:87–95

    Article  PubMed  CAS  Google Scholar 

  32. Schwiep F, Lewis ML (1984) Right ventricular end-systolic pressure-volume relations in intact dogs during alterations of preload and afterload. Fed Proc 43:509

    Google Scholar 

  33. Parker MM, Shelhamer JH, Bacharach SL et al (1984) Profound but reversible myocardial depression in patients with septic shock. Ann Intern Med 100:483–490

    PubMed  CAS  Google Scholar 

  34. Myers ML, Jacobson A, Finley R et al (1980) Beta receptor dysfunction in sepsis (Abstract) Crit Care Med 8:231

    Google Scholar 

  35. Lavensohm HS, Khouri EM, Gregg DE, Pyler RL et al (1976) Phasic right coronary artery blood flow in conscious dogs with normal and elevated right ventricle pressures. Circ Res 79:760–766

    Google Scholar 

  36. Brinker JA, Weiss JL, Lappe DL et al (1980) Leftward septal displacement during right ventricular loading in man. Circulation 61:626–638

    PubMed  CAS  Google Scholar 

  37. Sibbald WJ, Driedger AA, Myers ML, Shork AIK, Wells GA (1983) Biventricular function in the adult respiratory distress syndrome. Hemodynamic and radionuclide assessment, with special emphasis on right ventricular function. Chest 84:126–134

    Article  PubMed  CAS  Google Scholar 

  38. Brooks H, Kirk ES, Vokonas PS, Urschel CW, Sonnenblick EH (1971) Performance of the right ventricle under stress: Relation to right coronary flow. J Clin Invest 50:2176–2183

    Article  PubMed  CAS  Google Scholar 

  39. Newman JH (1985) Sepsis and pulmonary edema. Clin Chest Med 6:371

    PubMed  CAS  Google Scholar 

  40. Sibbald WJ, Short AIK, Driedger A, Wells GA (1985) The immediate effects of isosorbide dinitrate on right ventricular function in patients with acute hypoxemic respiratory failure - a combined invasive and radionuclide study. Am Rev Respir Dis 131(6): 826–868

    Google Scholar 

  41. Rutledge F, Chin D, Brown R, Driedger A, Sibbald W (1985) The effect of nitroglycerine on biventricular performance in ARDS. Crit Care Med 14(4): 386 (Abstract)

    Article  Google Scholar 

  42. Sibbald W, Driedger A, McCallum D, Cunningham D, Cheung H (in press) Nitroprusside infusion does not improve biventricular performance in patients with acute hypoxemic respiratory failure. J Crit Care

    Google Scholar 

  43. Chin D, Rutledge F, Brown R, Driedger A, Sibbald W (1985) The effect of dobutamine on biventricular function in ARDS. Clin and Invest Med 8(3):A65 (Abstract)

    Google Scholar 

  44. Ghignone M, Girling L, Prewitt RM (1984) Volume expansion versus norepinephrine in treatment of a low cardiac output complicating an acute increase in right ventricular after- load in dogs. Anesthesiology 60:132–135

    Article  PubMed  CAS  Google Scholar 

  45. Moran JM, Opravil M, Groitan AJ et al (1984) Pulmonary artery balloon counter-pulsation for right ventricular failure: II Clinical Experience. Ann Thor Surg 38:254–259

    Article  CAS  Google Scholar 

Download references

Authors

Editor information

Editors and Affiliations

Rights and permissions

Reprints and permissions

Copyright information

© 1987 Springer-Verlag Berlin Heidelberg

About this chapter

Cite this chapter

Oliphant, L.D., Sibbald, W.J. (1987). Right Ventricular Performance in the Adult Respiratory Distress Syndrome. In: Vincent, J.L., Suter, P.M. (eds) Cardiopulmonary Interactions in Acute Respiratory Failure. Update in Intensive Care and Emergency Medicine, vol 2. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-83010-5_3

Download citation

  • DOI: https://doi.org/10.1007/978-3-642-83010-5_3

  • Publisher Name: Springer, Berlin, Heidelberg

  • Print ISBN: 978-3-540-17474-5

  • Online ISBN: 978-3-642-83010-5

  • eBook Packages: Springer Book Archive

Publish with us

Policies and ethics