Journal of Applied Physiology
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J Appl Physiol (October 24, 2003). doi:10.1152/japplphysiol.00532.2003
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Submitted on May 19, 2003
Accepted on October 22, 2003

Decreasing size of cardiogenic oscillations reflects decreasing compliance of the respiratory system during long-term ventilation

Michael Lichtwarck-Aschoff1*, Bela Suki2, Anders Hedlund1, Ulf H Sjostrand1, Agneta Markstrom1, Rafael Kawati1, Goran Hedenstierna3, and Josef Guttmann4

1 Department of Surgical Sciences, Uppsala University, Uppsala, Sweden
2 Department of Biomedical Engineering, Boston University, Boston, USA
3 Department of Medical Sciences, Uppsala University, Uppsala, Sweden
4 Department of Anaesthesiology and Critical Care Medicine, Freiburg University, Freiburg, Germany

* To whom correspondence should be addressed. E-mail: m.lichtwarck-aschoff{at}t-online.de.

Part of the energy produced by the heartbeat is transferred to the lung and promotes in-trapulmonary gas mixing. It is likely that this transmission in the form of local mechanical disturbances both affects and reflects respiratory mechanics. The effects of the cardiogenic oscillations were studied in seven piglets during 7 hours of monotonous mechanical ventilation. During the first hour of ventilation, every heartbeat triggered a noticeable transient increase in lung volume of 14 mL (95% confidence interval 10 to 17 mL). After 7 hours, the increase in lung volume due to heartbeat significantly decreased to 7 mL (2 to 9 mL; p < 0.05). During the course of ventilation, overall lung compliance and gas exchange were progressively compromised. We conclude that 1) sufficient mechanical energy is transferred from the beating heart to the lung to increase lung volume, and 2) the ability of the heartbeats to help increase lung volume is reduced during long term ventilation, which reflects the changes in lung compliance.




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