J Clin Monit Comput - Pulmonary artery pulsatility is the main cause of cardiogenic oscillations.

Tópicos

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Resumo

The genesis of cardiogenic oscillations, i.e. the small waves in airway pressure (COS(paw)) and flow (COS(flow)) signals recorded at the airway opening is under debate. We hypothesized that these waves are originated from cyclic changes in pulmonary artery (PA) pressure and flow but not from the physical transmission of heartbeats onto the lungs. The aim of this study was to test this hypothesis. In 10 anesthetized pigs, COS were evaluated during expiratory breath-holds at baseline with intact chest and during open chest conditions at: (1) close contact between heart and lungs; (2) no heart-lungs contact by lifting the heart apex outside the thoracic cavity; (3) PA clamping at the main trunk during 10 s; and (4) during manual massage after cardiac arrest maintaining the heart apex outside the thorax, with and without PA clamping. Baseline COS(paw) and COS(flow) amplitude were 0.70 ? 0.08 cmH(2)O and 0.51 ? 0.06 L/min, respectively. Both COS amplitude decreased during open chest conditions in step 1 and 2 (p < 0.05). However, COS(paw) and COS(flow) amplitude did not depend on whether the heart was in contact or isolated from the surrounding lung parenchyma. COS(paw) and COS(flow) disappeared when pulmonary blood flow was stopped after clamping PA in all animals. Manual heart massages reproduced COS but they disappeared when PA was clamped during this maneuver. The transmission of PA pulsatilty across the lungs generates COS(paw) and COS(flow) measured at the airway opening. This information has potential applications for respiratory monitoring.

Resumo Limpo

genesi cardiogen oscil ie small wave airway pressur cospaw flow cosflow signal record airway open debat hypothes wave origin cyclic chang pulmonari arteri pa pressur flow physic transmiss heartbeat onto lung aim studi test hypothesi anesthet pig cos evalu expiratori breathhold baselin intact chest open chest condit close contact heart lung heartlung contact lift heart apex outsid thorac caviti pa clamp main trunk s manual massag cardiac arrest maintain heart apex outsid thorax without pa clamp baselin cospaw cosflow amplitud cmho lmin respect cos amplitud decreas open chest condit step p howev cospaw cosflow amplitud depend whether heart contact isol surround lung parenchyma cospaw cosflow disappear pulmonari blood flow stop clamp pa anim manual heart massag reproduc cos disappear pa clamp maneuv transmiss pa pulsatilti across lung generat cospaw cosflow measur airway open inform potenti applic respiratori monitor

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