Pinsky M R
J Appl Physiol Respir Environ Exerc Physiol. 1984 Mar;56(3):765-71. doi: 10.1152/jappl.1984.56.3.765.
The relationship between right atrial pressure (Pra) and venous return describes a venous return curve. Because changes in venous return and right ventricular stroke volume (SVRV) are similar during small tidal volume (VT) breathing, we compared the relationship of SVRV and Pra during positive-pressure ventilation (VT less than 10 ml/kg) in 17 pentobarbital-anesthetized, closed-chest, canine preparations. The SVRV-Pra relationship describes a straight line with a negative slope and a positive mean systemic pressure (Pms)-zero flow intercept (instantaneous Pms). Instantaneous Pms is similar to ventricular fibrillation-induced (stop-flow) Pms (8.1 +/- 0.8 vs. 8.4 +/- 0.7 mmHg, mean +/- SE). With volume infusion, both instantaneous and stop-flow Pms increase to a similar degree (R = 0.9014, P less than 0.001). The effect of opening an arteriovenous fistula is time dependent and variable between dogs, but by 30 s it is associated with an increase in instantaneous Pms (5.2 +/- 3.2 mmHg). Vascular compliance determined by adding and removing blood from the intravascular space displays a curvilinear hysteresis. The instantaneous venous return curve is affected by intravascular blood volume, vasomotor tone, and resistance to venous return. The relationship between SVRV and Pra during small VT breathing define instantaneous venous return curves similar to those described using right-heart bypass preparations.
右心房压力(Pra)与静脉回流量之间的关系描绘了一条静脉回流曲线。由于在小潮气量(VT)呼吸过程中静脉回流量和右心室每搏输出量(SVRV)的变化相似,我们在17只戊巴比妥麻醉、开胸的犬类实验准备中比较了正压通气(VT小于10 ml/kg)期间SVRV与Pra的关系。SVRV-Pra关系描绘了一条具有负斜率和正平均体循环压力(Pms)-零流量截距(瞬时Pms)的直线。瞬时Pms与心室颤动诱导的(停流)Pms相似(8.1±0.8对8.4±0.7 mmHg,平均值±标准误)。通过容量输注,瞬时和停流Pms均有相似程度的增加(R = 0.9014,P<0.001)。开放动静脉瘘的影响具有时间依赖性且犬之间存在差异,但到30秒时与瞬时Pms增加相关(5.2±3.2 mmHg)。通过向血管内空间添加和移除血液所确定的血管顺应性呈现出曲线滞后现象。瞬时静脉回流曲线受血管内容量、血管运动张力和静脉回流阻力的影响。小VT呼吸期间SVRV与Pra的关系定义了与使用右心旁路实验准备所描述的相似的瞬时静脉回流曲线。