Механизмы взаимодействия сердечно-сосудистой и дыхательной систем

Abstract

In this review we discuss the mechanisms of cardio-pulmonary interaction during spontaneous respiration and mechanical lung ventilation. We noted the interrelations between the changes of the intrathoracic pressure, venous return and cardiac output; the changes of the intrathoracic pressure and pulmonary hemodynamics; the values of the intrathoracic pressure and right and left ventricular myocardial contractility; the changing of respiratory phases and heart rate; the changes of respiratory muscles contraction and circulatory system. The phasic changes of the venous flow (it increases during respiration and decreases during expiration) are caused by the changes of both the intrathoracic and transdiaphragmatic pressures. However, the sucking thoracic effect is practically absent to the mean values of the venous return. During phasic respiratory changes the shifts of the venous return and pulmonary artery flow are opposite to the changes of the cardiac output and arterial pressure as a result of the changes of capacitance and resistance of the pulmonary vessels. In case of positive end expiratory pressure ventilation the changes of the cardiac output are dependent from the interrelations of the venous return, right ventricular myocardial contractility, pulmonary veins outflow and left ventricular myocardial contractility. The reflectory neurogenic influences on the heart and vessels from the pulmonary and respiratory muscles receptors are important during the cardio-pulmonary interaction.