Influence of positive airway pressure on the pressure gradient for venous return in humans
Influence of positive airway pressure on the pressure gradient for venous return in humans
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DOI：
10.1152/jappl.2000.88.3.926
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发表时间：
2000-03-01
影响因子：
3.3
通讯作者：
Fitzgerald, RD
中科院分区：
文献类型：
--
作者：
Jellinek, H;Krenn, H;Fitzgerald, RD
为探讨正压(Paw)对静脉返流压力梯度[平均系统充盈压(Pms)与右心房压(Pra)之差]的影响，对10例患者在呼吸暂停0~15cmH(2)O时，Paw由0~15cmH(2)O变化，Pra由7.3+/-3.1增至10.0+/-2.3 mm Hg，每搏输出量减少23+/-22%。在0-和15-cmH(2)O Paw期间进行除颤器试验诱发的室颤发作，以测量PMS(循环骤停后的Pra7.5 S的值)。PAW阳性使PMS从10.2+/-3.5升至12.7+/-3.2 mm Hg，因此静脉回流压力梯度(PMS-Pra)保持不变。超声心动图未发现肺扩张导致下腔静脉和上腔静脉血管塌陷的迹象。总而言之，我们证明了，在人类中，正Paw同样增加了Pra和PMS，并改变了静脉回流，而不改变压力梯度(PMS-Pra)。
To study the effect of positive airway pressure (Paw) on the pressure gradient for venous return [the difference between mean systemic filling pressure (Pms) and right atrial pressure (Pra)], we investigated 10 patients during general anesthesia for implantation of defibrillator devices,Paw was varied under apnea from 0 to 15 cmH(2)O, which increased Pra From 7.3 +/- 3.1 to 10.0 +/- 2.3 mmHg and decreased left ventricular stroke volume by 23 +/- 22%. Episodes of ventricular fibrillation, induced for defibrillator testing, were performed during 0- and 15-cmH(2)O Paw to measure Pms (value of Pra 7.5 s after onset of circulatory arrest). Positive Paw increased Pms from 10.2 +/- 3.5 to 12.7 +/- 3.2 mmHg, and thus the pressure gradient for venous return (Pms - Pra) remained unchanged. Echocardiography did not reveal signs of vascular collapse of the inferior and superior vena cava due to lung expansion. In conclusion, we demonstrated that; positive Paw equally increases Pra and Pms in humans and alters venous return without changes in the pressure gradient (Pms - Pra).