Update 1988 pp 753-758 | Cite as

Mechanical Ventilation in Cardiogenic and Septic Shock

  • C. Roussos
Part of the Update in Intensive Care and Emergency Medicine book series (UICM, volume 5)


Hypoxemic or hypercapnic respiratory failure has traditionally been the main cause of mechanical ventilation. Although respiratory failure is a frequent complication of shock, the use of mechanical ventilation has been instituted only when severe gas exchange abnormalities occurred. We maintain that mechanical ventilation should be instituted early in the course of shock for two reasons:
  1. 1

    to put the respiratory muscles at rest, and thereby avoid respiratory muscle fatigue, and

  2. 2

    to free blood from the working respiratory muscles. The blood can, in turn, supply vital organs.



Cardiac Output Mechanical Ventilation Septic Shock Cardiogenic Shock Lactic Acidosis 
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 Ch (1981) Respiratory muscle fatigue during cardiogenic shock. J Appl Physiol 51:499–508.PubMedGoogle Scholar
  2. 2.
    Hussain SNA, Simkus G, Roussos Ch (1985) Ventilatory muscle fatigue, the cause of respiratory failure in septic shock. J Appl Physiol 58:2033–2040.PubMedGoogle Scholar
  3. 3.
    Viires N, Sillye G, Aubier M, Rassidakis A, Roussos Ch (1983) Regional bood flow distribution in dog during induced hypotension and low cardiac output. Spontaneous breathing versus artificial ventilation. J Clin Invest 72:935–947.PubMedCrossRefGoogle Scholar
  4. 4.
    Aubier M, Viires N, Sillye G, Mozes R, Roussos Ch (1982) Respiratory muscle contribution to lactic acidosis in low cardiac output. Am Rev Respir Dis 126:642–652.Google Scholar
  5. 5.
    Hussain S, Roussos Ch (1985) Distribution of respiratory muscle and organ blood flow during endotoxin shock in dogs. J Appl Physiol 59:1802–1808.PubMedGoogle Scholar
  6. 6.
    Peretz DI, McGregor M, Dossetor JB (1964) Lactic acidosis: a clinically significant aspect of shock. Can Med Assoc J 90:673–675.PubMedGoogle Scholar
  7. 7.
    Vincent JL, Dufaye P, Berré J, Leeman M, Degaute JP, Kahn RJ (1983) Serial lactate determinations during circulatory shock. Crit Care Med 11:449–451.PubMedCrossRefGoogle Scholar
  8. 8.
    Blair E, Cowley A, Tait MK (1965) Refractory septic shock in man: role of lactate and pyruvate metabolism in prognosis. Ann Surg 31:537–540.Google Scholar
  9. 9.
    Field S, Kelly SM, Macklem PT (1982) The oxygen cost of breathing in patients with cardiorespiratory disease. Am Rev Respir Dis 126:9–13.PubMedGoogle Scholar
  10. 10.
    Burzstein S, Taitelman U, DeMyttenaere S, et al (1978) Reduced oxygen consumption in catabolic states with mechanical ventilation. Crit Care Med 6:162–168.CrossRefGoogle Scholar
  11. 11.
    Bjork VO, Grenvik A, Holmdahl MH, Westerholm CJ (1964) Cardiac output and oxygen consumption during respiratory treatment. Acta Anaesth Scand (supp) 15:158–160.CrossRefGoogle Scholar
  12. 12.
    Robotham JL, Scharf SM (1983) Effects of positive and negative pressure ventilation on cardiac performance. Clin Chest Med 4:161–187.PubMedGoogle Scholar
  13. 13.
    Luce JM (1984) The cardiovascular effects of mechanical ventilation and positive end expiratory pressure. JAMA 252:807–811.PubMedCrossRefGoogle Scholar
  14. 14.
    Ashbaugh CG, Petty TL (1973) Positive end-expiratory pressure physiology, indications and contraindications. J Thor Cardiovas Surg 65:165.Google Scholar
  15. 15.
    Qvist J, Pontoppidan H, Wilson RS, Lowenstein E, Laver MB (1975) Hemodynamic responses to mechanical ventilation with PEEP. Anaesthesiology 42:45–55.CrossRefGoogle Scholar
  16. 16.
    Grindlinger GA, Manny J, Justice R, Dunham, Shepro D, Heshtman HB (1979) Presence of negative inotropic agents in caning plasma during positive end-expiratory pressure. Circ Res 45:460–467.PubMedGoogle Scholar
  17. 17.
    Click G, Weschler AS, Epstein SE (1969) Reflex cardiovascular depression produced by stimulation of pulmonary stretch receptors in the dog. J Clin Invest 48:467–473.CrossRefGoogle Scholar
  18. 18.
    Marthru M (1985) Mechanical breath; non-pharmacologic support for a failing heart? Chest 85:1.CrossRefGoogle Scholar
  19. 19.
    Ellman H, Dembin H (1982) Lack of adverse hemodynamic effects of PEEP in patients with acute respiratory failure. Crit Care Med 10:706–711.PubMedCrossRefGoogle Scholar
  20. 20.
    Calvin JE, Driedser AA, Sibbald WJ (1981) Positive end-expiratory pressure does not depress left ventricular function in patients with edema. Am Rev Respir Dis 124:121–128.PubMedGoogle Scholar
  21. 21.
    Beach T, Milien E, Grenvik A (1973) Hemodynamic response to discontinuation of mechanical ventilation. Crit Care Med 1:85–90.PubMedCrossRefGoogle Scholar
  22. 22.
    Pinsky MR, Summer WR (1983) Cardiac augmentation by phasic high intrathoracic pressure support in man. Chest 84:370–375.PubMedCrossRefGoogle Scholar
  23. 23.
    Pinsky MR, Summer WR, Wise RH, et al (1983) Augmentation of cardiac function by elevation of intrathoracic pressure. J Appl Physiol 54:950–955.PubMedGoogle Scholar
  24. 24.
    Prewitt RM, Oppenheimer L, Sutherland JB, Wood LDH (1981) Effect of positive end-expiratory pressure on left ventricular mechanics in patients with hypoxemic respiratory failure. Anaesthesiology 55:409–415.CrossRefGoogle Scholar
  25. 25.
    Crace MR, Greenham DM (1982) Cardiac performance in response to PEEP in patients with cardiac dysfunction. Crit Care Med 10:358–360.CrossRefGoogle Scholar
  26. 26.
    Criley JM, Balfuss Ah, Vissel GL (1976) Cough-induced cardiac compression: self-administered form of cardiopulmonary resuscitation. JAMA 236:1246–1250.PubMedCrossRefGoogle Scholar
  27. 27.
    Chandra N, Weisfeldt ML, Tsitlik J, et al (1981) Augmentation of carotid flow during cardiopulmonary resuscitation by ventilation at high airway pressure with chest compression. Am J Cardiol 48:1053–1063.PubMedCrossRefGoogle Scholar
  28. 28.
    Rosborough JP, Nieman JT, Griley JM, et al (1981) Lower abdominal compression with synchronized ventilation; a CPR modality. Circulation 64 (suppl 4):303 (Abstract).Google Scholar
  29. 29.
    Niemann JT, Rosborough JP, Niskanen RA, Criley JM (1984) Circulatory support during cardiac arrest using a pneumatic vest and abdominal binder with simultaneous high-pressure airway inflation. Ann Emerg Med 13:270–277.Google Scholar
  30. 30.
    Passerini L, Wise RA, Roussos Ch (1985) Maintenance of circulation during CPR with mechanical ventilation. Clin Invest Med 8:R164.Google Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 1988

Authors and Affiliations

  • C. Roussos

There are no affiliations available

Personalised recommendations