Relation between transpulmonary pressure and right ventricular isovolumetric pressure change during respiratory support

1989 ◽  
Vol 16 (4) ◽  
pp. 215-220 ◽  
Author(s):  
François Jardin ◽  
Dominique Brun-Ney ◽  
Pierre Cazaux ◽  
Olivier Dubourg ◽  
Anne Hardy ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Transpulmonary Pressure ◽  
Pressure Change ◽  
Respiratory Support

Change in extra-alveolar perimicrovascular pressure with lung inflation

1984 ◽  
Vol 57 (3) ◽  
pp. 772-776 ◽  
Author(s):  
A. C. Jasper ◽  
H. S. Goldberg
Keyword(s):  
Hydrostatic Pressure ◽  
Volume Change ◽  
Transpulmonary Pressure ◽  
Pressure Change ◽  
Dry Mass ◽  
Interstitial Pressure ◽  
Autologous Plasma ◽  
Lung Inflation ◽  
Pulmonary Arterial ◽  
Over Time

In eight isolated dog lobes, we examined the change in extra-alveolar perimicrovascular hydrostatic pressure (Pis) due to lung inflation. The vasculature was filled with autologous plasma. Pulmonary arterial and venous lines were connected to a common plasma reservoir. Perimicrovascular volume change (delta Vis), compliance (Cis), and the microvascular filtration coefficient (Kf) were derived from the change in lobe mass over time following a step increase in vascular pressure (Piv). Initially, transpulmonary pressure (PL) was 5 cmH2O and Piv = 0 cmH2O. At constant Piv, two sequential 5-cmH2O increases in PL increased Vis; division of delta Vis by Cis yielded the change in Pis attributable to lung inflation. Cis was 0.035 +/- 0.018 g X cmH2O–1 X g dry mass-1 (mean +/- SD) at PL = 15 cmH2O. Kf was 0.019 +/- 0.023 g X min-1 X cmH2O–1 X g dry mass-1. With inflation from PL = 5 to PL = 10 cmH2O, Pis = -2.15 +/- 1.76 cmH2O; from PL = 10 to PL = 15 cmH2O, Pis = -2.25 +/- 1.50 cmH2O. This perimicrovascular pressure change is very close to the perihilar interstitial pressure change reported by others. Such near equality suggests that the stress of lung inflation is very uniformly applied to the interstitial continuum.

scholarly journals Right ventricular unloading and respiratory support with a wearable artificial pump-lung in an ovine model

2014 ◽  
Vol 33 (8) ◽  
pp. 857-863 ◽  
Author(s):  
Yang Liu ◽  
Pablo G. Sanchez ◽  
Xufeng Wei ◽  
Tieluo Li ◽  
Amelia C. Watkins ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Respiratory Support ◽  
Ovine Model

scholarly journals Novel method of transpulmonary pressure measurement with an air-filled esophageal catheter

2021 ◽  
Author(s):  
Paul B Massion ◽  
J Berg ◽  
N Samalea ◽  
G Parzibut ◽  
B Lambermont ◽  
...  
Keyword(s):  
Balloon Catheter ◽  
Transpulmonary Pressure ◽  
Pressure Change ◽  
Esophageal Pressure ◽  
Protective Ventilation ◽  
Suction Catheter ◽  
Reproducible Method ◽  
Novel Method ◽  
Flush Device

Abstract Background There is a strong rationale for proposing transpulmonary pressure-guided protective ventilation in acute respiratory distress syndrome (ARDS). The reference esophageal balloon catheter method requires complex in vivo calibration and dedicated ventilator with auxiliary pressure port. A simple, inexpensive, accurate and reproducible method of measuring esophageal pressure would greatly facilitate the measure of transpulmonary pressure to individualize protective ventilation in the intensive care unit. Results We propose an air-filled esophageal catheter method without balloon, using disposable catheter and transducer that allows reproducible esophageal pressure measurements, and that does not require any specific ventilator equipment. We use a 49 cm-long thin low compliance polyvinyl 10 Fr suction catheter, positioned in the lower third of the esophagus and connected to an air-filled disposable blood pressure transducer bound to the monitor. To guarantee air transmission, the transducer is pressurized by an air-filled infusion bag allowing its integrated flush device to deliver continuous air flow and to obtain a stable esophageal waveform. Calibration requires simple zeroing the transducer open to atmospheric pressure. Esophageal pressures recorded on the monitoring are expressed in mmHg and need to be converted in cmH2O. We tested our novel method in 10 consecutive intubated patients with severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) infection. We calculated the target transpulmonary pressures for protective lung and diaphragm ventilation, both in passive and spontaneously breathing conditions. Esophageal to airway pressure change ratio was close to one in both conditions (median [P25;P75] = 0.94 [0.92;1.00] and 0.98 [0.96;1.01]). We adjusted ventilator settings towards recommended pressure targets to limit atelectrauma, barotrauma, inspiratory effort and lung stress, by modifying positive end-expiratory pressure, tidal volume, or inspiratory pressure accordingly. Conclusions We propose a simple, inexpensive and reproducible method for esophageal pressure monitoring with an air-filled esophageal catheter without balloon. It holds the promise of widespread bedside use of transpulmonary pressure-guided protective ventilation in patients with ARDS.

Abstract 14397: Sotatercept Analog RAP-011 Inhibits Right Ventricular Remodeling and Restores Function in a Mouse Model of Pressure Overload

Circulation ◽  
2020 ◽  
Vol 142 (Suppl_3) ◽  
Author(s):  
Sachindra R Joshi ◽  
Jun Liu ◽  
R. Scott Pearsall ◽  
Patrick Andre ◽  
Gang Li ◽  
...  
Keyword(s):  
Mouse Model ◽  
Right Ventricular ◽  
Ventricular Remodeling ◽  
Pressure Overload ◽  
Standard Of Care ◽  
Pressure Change ◽  
Therapeutic Effects ◽  
Beneficial Effects ◽  
Post Surgery ◽  
And Function

IIntroduction: Right ventricular (RV) failure is the primary cause of death in patients with pulmonary arterial hypertension (PAH). Beneficial effects of sotatercept - an activin receptor type IIA-Fc fusion protein that traps activins and growth differentiation factors - have been reported in PAH patients treated with standard-of-care therapies in a recent phase 2 study (PULSAR). We have reported that therapeutic treatment with sotatercept analog RAP-011 reverses RV remodeling and function in rats with severe angio-obliterative PAH, providing benefits on top of standard care. Hypothesis: To determine whether RAP-011 exerts a direct cardioprotective effect in a mouse model of pressure overload-induced RV failure. Methods: RV failure was induced in male C57BL/6 mice by pulmonary artery banding (PAB). RAP-011 or vehicle were administered subcutaneously twice weekly for 3 weeks beginning one day post surgery. RV remodeling and function were assessed by echocardiography and RV pressure measured by catheterization. RV fibrosis was assessed by Masson’s trichrome staining. Results: PAB caused RV hypertrophy and increased RV wall thickness in comparison to sham surgery. RAP-011 treatment markedly attenuated these PAB-induced changes (by 72% and 41%, respectively; P < 0.0001). PAB significantly reduced tricuspid annular plane systolic excursion (0.68 ± 0.03 vs. 0.98 ± 0.03 mm), which was partially restored by RAP-011 (0.84 ± 0.04 mm; P < 0.01). In addition, the PAB-induced increase in myocardial performance index was reversed by RAP-011 (1.86 vs. 1.48, P < 0.0001). RAP-011 attenuated PAB-induced RV developed pressure (by 82%, P < 0.0001) and partially normalized peak rates of RV pressure change (+dP/dt max and -dP/dt min , P < 0.05). RAP-011 also reduced the extent of PAB-induced RV fibrosis (19.5% vs. 10.5%, P < 0.001). Conclusions: Consistent with our previous findings in a rat model of severe angio-obliterative PAH, RAP-011 treatment reduces RV remodeling and improves function in a PAB model, thus implicating direct cardioprotective actions of RAP-011 as an important component of its therapeutic effects in severe experimental PAH.

Ambulatory Oxygenator Right Ventricular Assist Device for Total Right Heart and Respiratory Support

2007 ◽  
Vol 84 (5) ◽  
pp. 1699-1703 ◽  
Author(s):  
Dongfang Wang ◽  
Scott D. Lick ◽  
Xiaoqin Zhou ◽  
Xiaojun Liu ◽  
Robert J. Benkowski ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Assist Device ◽  
Respiratory Support ◽  
Right Heart ◽  
Assist Device ◽  
Ventricular Assist ◽  
Right Ventricular Assist Device

Combined Thermodilution and Two-Dimensional Echocardiographic Evaluation of Right Ventricular Function during Respiratory Support with PEEP

CHEST Journal ◽  
1991 ◽  
Vol 99 (1) ◽  
pp. 162-168 ◽  
Author(s):  
François Jardin ◽  
Dominique Brun-Ney ◽  
Anne Hardy ◽  
Philippe Aegerter ◽  
Alain Beauchet ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Respiratory Support ◽  
Two Dimensional ◽  
Echocardiographic Evaluation

scholarly journals O-017 Right Ventricular Function In Infants With Severe Bronchiolitis And Different Respiratory Support: Abstract O-017 Table 1

2014 ◽  
Vol 99 (Suppl 2) ◽  
pp. A28.2-A28
Author(s):  
L Rodriguez Guerineau ◽  
L Pérez Baena ◽  
S Segura Matute ◽  
J Bartrons ◽  
M Pons-Odena ◽  
...  
Keyword(s):  
Right Ventricular ◽  
Ventricular Function ◽  
Right Ventricular Function ◽  
Respiratory Support

scholarly journals Right ventricular function mirrors clinical improvement with use of prostacyclin analogues in pediatric pulmonary hypertension

2018 ◽  
Vol 8 (2) ◽  
pp. 204589401875924 ◽  
Author(s):  
Rachel K. Hopper ◽  
Yan Wang ◽  
Valerie DeMatteo ◽  
Ashley Santo ◽  
Steven M. Kawut ◽  
...  
Keyword(s):  
Pulmonary Hypertension ◽  
Right Ventricular ◽  
Global Longitudinal Strain ◽  
Clinical Information ◽  
Pressure Change ◽  
Functional Class ◽  
Clinical Markers ◽  
Pulmonary Arterial ◽  
Rv Function ◽  
Prostacyclin Analogues

Pulmonary hypertension (PH) causes significant morbidity and mortality in children due to right ventricular (RV) failure. We sought to determine the effect of prostacyclin analogues on RV function assessed by echocardiography in children with PH. We conducted a retrospective cohort study of children with PH treated with a prostacyclin analogue (epoprostenol or treprostinil) between January 2001 and August 2015 at our center. Data were collected before initiation of treatment (baseline) and at 1–3 and 6–12 months after. Protocolized echocardiogram measurements including tricuspid annular plane systolic excursion (TAPSE) and RV global longitudinal strain were made with blinding to clinical information. Forty-nine individuals (65% female), aged 0–29 years at the time of prostacyclin initiation were included. Disease types included pulmonary arterial hypertension (idiopathic [35%], heritable [2%], and congenital heart disease-associated [18%]), developmental lung disease (43%), and chronic thromboembolic PH (2%). Participants received intravenous (IV) epoprostenol (14%) and IV/subcutaneous (SQ) (67%) or inhaled (18%) treprostinil. Over the study period, prostacyclin analogues were associated with improvement in TAPSE ( P = 0.007), RV strain ( P < 0.001), and qualitative RV function ( P = 0.037) by echocardiogram, and BNP ( P < 0.001), functional class ( P = 0.047) and 6-min walk distance ( P = 0.001). TAPSE and strain improved at early follow up ( P = 0.05 and P = 0.002, respectively) despite minimal RV pressure change. In children with PH, prostacyclin analogues are associated with an early and sustained improvement in RV function measured as TAPSE and strain as well as clinical markers of PH severity. RV strain may be a sensitive marker of RV function in this population.

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