Respiratory Muscle Fatigue During Cardiogenic Shock
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In patients with cardiogenic shock, the work of breathing is generally increased due to hyperventilation elicited by acidemia and hypoxemia and alterations in pulmonary mechanics secondary to pulmonary vascular congestion. However, in consequence to the decreased cardiac output, respiratory muscle blood flow may be limited to levels less than those required by the increased work of breathing. Respiratory muscle fatigue may then occur, leading to respiratory failure. In addition, since the respiratory muscles are the only muscles working during low cardiac output, they may receive a large part of the cardiac output. As a consequence, less blood flow will be available for other skeletal muscles and vital organs; the latter might then contribute to excess blood lactate either by increased production and/or impaired lactate removal.
KeywordsCardiac Output Cardiogenic Shock Lactic Acidosis Respiratory Muscle Phrenic Nerve
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- 1.Aubier M, Trippenbach T, Roussos C (1981) Respiratory muscle during cardiogenic shock. J App Physiol 51: 499–508Google Scholar