Amelioration de la perfusion des organes vitaux par la valve d'impedance inspiratoire et le concept de pompe respiratoire: rationnel physiologique et application clinique (Improving Vital Organs Perfusion by the Respiratory Pump: Physiology and Clinical Use)
ARMY INST OF SURGICAL RESEARCH FORT SAM HOUSTON TX
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Primary function of breathing is to provide gas exchange. Studies of the mechanisms involved in animals and humans provide the physiological underpinnings for the other side of breathing to increase circulation to the heart and brain. We describe studies that focus on the fundamental relationship between the generation of negative intrathoracic pressure during inspiration through a low-level of resistance created by an impedance threshold device and the physiologic effects of a respiratory pump. A decrease in intrathoracic pressure during inspiration through a fixed resistance resulting in an intrathoracic pressure of -7 cmH2O has multiple physiological benefits including enhanced venous return, cardiac stroke volume and aortic blood pressure lower intracranial pressure resetting of the cardiac baroreflex elevated cerebral blood flow oscillations and increased tissue blood flowpressure gradient. The clinical and animal studies support the use of the intrathoracic pump to treat different clinical conditions hemorrhagic shock, orthostatic hypotension, septic shock, and cardiac arrest.
- Medicine and Medical Research