Update 1987 pp 213-222 | Cite as

Pulmonary Blood Flow and Blood Volume During Positive Pressure Ventilation

  • A. Versprille
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 3)

Abstract

Flow and pressure in the systemic and pulmonary circulation are affected by two types of changes in airway pressure: a static type applied for a relatively long time like positive end-expiratory pressure (PEEP), and a dynamic type of rise and fall during each ventilatory cycle. In both types, the increase in airway pressure will increase intrathoracic and central venous pressure. Consequently, a decrease in venous return occurs [1–8]. However, for both types, the same rise in airway pressure will not have the same quantitative effect, because during PEEP two additional control mechanisms are involved. A lung stretch reflex is increasing the negative effects of central venous pressure on flow and arterial blood pressure [8–10], and control mechanisms elicited by baroreceptor activity are compensating for these negative effects [8, 11]. During a ventilatory cycle, the time of rise and fall in airway pressure is too short to elicit these neurogenic and humoral control mechanisms. Changes in circulation during a ventilatory cycle, therefore, will be mainly due to direct mechanical effects.

Keywords

Depression Respiration 

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© Springer-Verlag Berlin Heidelberg 1987

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  • A. Versprille

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