Right ventricular performance in adult respiratory distress syndrome. 1990

J F Dhainaut, and F Brunet
Medical Intensive Care Unit, Cochin Port-Royal University-Hospital, Paris, France.

In adult respiratory distress syndrome (ARDS), the pulmonary artery hypertension is followed by increases in right ventricular diastolic and systolic volumes and a decreased ejection fraction. The stroke volume is preserved by the Frank-Starling mechanism as preload increases, even in the presence of severe pulmonary artery hypertension. In contrast, if there coexists a depression of the right ventricle contractility, as during right ventricular contusion, septic shock or a viral myocarditis, the compensatory Frank-Starling mechanism, that maintains right ventricular pump function, seems limited. Thus, it appears that the contractile state of the right ventricle can influence the clinical course of ARDS. In addition, patients with ARDS require mechanical ventilation with positive end-expiratory pressure (PEEP), which has a detrimental effect on right ventricular loading conditions. Most investigators agree that the most important effect is a decreased right ventricular preload, secondary to the increased pleural pressure due to PEEP. However, in patients with severe pulmonary artery hypertension, the PEEP-induced increase in right ventricular afterload may become more preponderant, and inotropic support to maintain right ventricular stroke volume may be necessary.

UI MeSH Term Description Entries
D009200 Myocardial Contraction Contractile activity of the MYOCARDIUM. Heart Contractility,Inotropism, Cardiac,Cardiac Inotropism,Cardiac Inotropisms,Contractilities, Heart,Contractility, Heart,Contraction, Myocardial,Contractions, Myocardial,Heart Contractilities,Inotropisms, Cardiac,Myocardial Contractions
D011175 Positive-Pressure Respiration A method of mechanical ventilation in which pressure is maintained to increase the volume of gas remaining in the lungs at the end of expiration, thus reducing the shunting of blood through the lungs and improving gas exchange. Positive End-Expiratory Pressure,Positive-Pressure Ventilation,End-Expiratory Pressure, Positive,End-Expiratory Pressures, Positive,Positive End Expiratory Pressure,Positive End-Expiratory Pressures,Positive Pressure Respiration,Positive Pressure Ventilation,Positive-Pressure Respirations,Positive-Pressure Ventilations,Pressure, Positive End-Expiratory,Pressures, Positive End-Expiratory,Respiration, Positive-Pressure,Respirations, Positive-Pressure,Ventilation, Positive-Pressure,Ventilations, Positive-Pressure
D011651 Pulmonary Artery The short wide vessel arising from the conus arteriosus of the right ventricle and conveying unaerated blood to the lungs. Arteries, Pulmonary,Artery, Pulmonary,Pulmonary Arteries
D011652 Pulmonary Circulation The circulation of the BLOOD through the LUNGS. Pulmonary Blood Flow,Respiratory Circulation,Circulation, Pulmonary,Circulation, Respiratory,Blood Flow, Pulmonary,Flow, Pulmonary Blood,Pulmonary Blood Flows
D012128 Respiratory Distress Syndrome A syndrome characterized by progressive life-threatening RESPIRATORY INSUFFICIENCY in the absence of known LUNG DISEASES, usually following a systemic insult such as surgery or major TRAUMA. ARDS, Human,Acute Respiratory Distress Syndrome,Adult Respiratory Distress Syndrome,Pediatric Respiratory Distress Syndrome,Respiratory Distress Syndrome, Acute,Respiratory Distress Syndrome, Adult,Respiratory Distress Syndrome, Pediatric,Shock Lung,Distress Syndrome, Respiratory,Distress Syndromes, Respiratory,Human ARDS,Lung, Shock,Respiratory Distress Syndromes,Syndrome, Respiratory Distress
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D014655 Vascular Resistance The force that opposes the flow of BLOOD through a vascular bed. It is equal to the difference in BLOOD PRESSURE across the vascular bed divided by the CARDIAC OUTPUT. Peripheral Resistance,Total Peripheral Resistance,Pulmonary Vascular Resistance,Systemic Vascular Resistance,Peripheral Resistance, Total,Resistance, Peripheral,Resistance, Pulmonary Vascular,Resistance, Systemic Vascular,Resistance, Total Peripheral,Resistance, Vascular,Vascular Resistance, Pulmonary,Vascular Resistance, Systemic
D016278 Ventricular Function, Right The hemodynamic and electrophysiological action of the right HEART VENTRICLE. Right Ventricular Function,Function, Right Ventricular,Functions, Right Ventricular,Right Ventricular Functions,Ventricular Functions, Right

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