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Heart–Lung Interactions and Cardiovascular Support in Pediatric Acute Respiratory Distress Syndrome

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Pediatric Acute Respiratory Distress Syndrome

Abstract

The acute respiratory distress syndrome (ARDS) is characterized by bilateral diffuse alveolar disease on radiograph, restrictive lung physiology, a decrease in functional residual capacity (FRC), intrapulmonary shunt, and arterial hypoxemia. In ARDS, significant positive airway pressure is often needed in order to restore and maintain an adequate FRC. Despite improving oxygenation, the use of positive airway pressure may lead to a decrement in cardiac output (CO), negating the increase in oxygen content, or in more severe cases a decrease in systemic oxygen delivery (DO2). In this chapter, we will discuss the physiologic underpinnings of heart–lung interactions, with an emphasis on the impact of positive airway pressure on right ventricular (RV) loading conditions and output and the salient aspects of the pathophysiology of ARDS in order to discuss the impact, assessment, and treatment of positive pressure ventilation (PPV)-induced cardiovascular dysfunction in pediatric ARDS.

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Author information

Authors and Affiliations

  1. Section of Critical Care Medicine and Cardiology, Texas Children’s Hospital, Department of Pediatrics, Baylor College of Medicine, Houston, TX, USA

    Saul Flores & Ronald A. Bronicki

  2. Section of Cardiology, Division of Cardiology, Department of Pediatrics, Chicago Medical School, Advocate Children’s Hospital, Oak Lawn/Chicago, IL, USA

    Rohit S. Loomba

Authors
  1. Saul Flores
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  2. Rohit S. Loomba
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  3. Ronald A. Bronicki
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Corresponding author

Correspondence to Ronald A. Bronicki .

Editor information

Editors and Affiliations

  1. Rainbow Babies & Children’s Hospital, Case Western Reserve University, Cleveland, OH, USA

    Steven L. Shein

  2. Duke University School of Medicine, Duke University Medical Center, Durham, NC, USA

    Alexandre T. Rotta

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Flores, S., Loomba, R.S., Bronicki, R.A. (2020). Heart–Lung Interactions and Cardiovascular Support in Pediatric Acute Respiratory Distress Syndrome. In: Shein, S., Rotta, A. (eds) Pediatric Acute Respiratory Distress Syndrome. Springer, Cham. https://doi.org/10.1007/978-3-030-21840-9_13

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  • DOI: https://doi.org/10.1007/978-3-030-21840-9_13

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-030-21839-3

  • Online ISBN: 978-3-030-21840-9

  • eBook Packages: MedicineMedicine (R0)

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