Abstract
Intermittent positive pressure ventilation induces cyclic changes in the loading conditions of right and left ventricles. Mechanical insufflation decreases preload and increases afterload of the right ventricle [1, 2]. The right ventricular (RV) preload reduction is due to the decrease of the venous return pressure gradient related to the inspiratory increase in pleural pressure [1]. The increase in RV afterload is related to the inspiratory increase in transpulmonary pressure (alveolar minus pleural pressure) [3]. The reduction in RV preload and the increase in RV afterload both lead to a decrease in RV stroke volume which is minimum at the end of the inspiratory period. The inspiratory impairment of venous return is assumed to be the main mechanism of the reduction in the inspiratory RV ejection [4].
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