Respiratory Muscle Fatigue During Cardiogenic Shock

Conference paper
Part of the Anaesthesiologie und Intensivmedizin / Anaesthesiology and Intensive Care Medicine book series (A+I, volume 178)


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.


Cardiac Output Cardiogenic Shock Lactic Acidosis Respiratory Muscle Phrenic Nerve 
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© Springer-Verlag Berlin Heidelberg 1985

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