Abstract
The role of the right ventricle (RV) in maintaining cardiovascular homeostasis is controversial. In the past, its role in maintaining cardiac output was considered minimal [1]. Similarly, it is difficult to study RV function, owing to inadequacies in modeling of the RV volume and pressure responses to interventions used to define its behavior [2]. Thus, RV function has been poorly studied. Recent advances in indicator dilution technology and nuclear cardiology have increased our understanding of the processes involved in many disease states associated with RV dysfunction [2]. These studies suggest that the RV is very important in maintaining cardiac output under conditions of increased pulmonary vascular resistance, pulmonary hypertension and when increased oxygen demand requires proportional increases in cardiac output. These conditions exist in a variety of diseases commonly seen in critically ill patients, such as chronic obstructive lung disease, acute hypoxemic respiratory failure, and traumatic shock states. Furthermore, new catheter technologies have increased the availability of measurements of RV pressures and volume at the bedside. These collective changes in our understanding of disease processes and in our ability to measure RV pressures and volume may lead to an improved management of the critically ill.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Starr I, Jeffers WA, Meade RH Jr (1943) The absence of conspicuous increments of venous pressure after severe damage to the right ventricle of the dog, with a discussion of the relation between clinical congestive heart failure and heart disease. Am Heart J 26: 291–311
Matthay RA, Biondi JW, Schulman DS, Wiedermann HP (1988) Acute right heart failure-pathogenesis, diagnosis and therapy. Appl Cardiopulm Pathophysiol 2: 59–83
Taylor RR, Covell JW, Sonnenblick ER, Ross J Jr (1967) Dependence of ventricular distensibility on filling of the opposite ventricle. Am J Physiol 213: 711–718
Pinsky MR (1984) Instantaneous venous return curves in an intact canine preparation. J Appl Physiol 56: 765–771
Pinsky MR (1984) Determinants of pulmonary artery flow variation during respiration. J Appl Physiol 56: 1237–1245
Raines RA, LeWinter MM, Covell JW (1976) Regional shortening patterns in canine right ventricle. Am J Physiol 218: 1395–1402
Janicki JS, Weber KT (1980) The pericardium and ventricular interaction, distensibility and function. Am J Physiol 238: H494–H503
Tyberg JY, Taichman GC, Smith ER, Douglas NWS, Smiseth OA, Keon WJ (1986) The relationship between pericardial pressure and right atrial pressure: An intraoperative study. Circulation 73: 428–432
Suga H, Sugawa K (1974) Instantaneous pressure-volume relations and their ratio in the excised, supported canine left ventricle. Circ Res 35: 117–126
Maughan WL, Shoukas AA, Sugawa K, Weisfeldt ML (1979) Instantaneous pressure- volume relations of the canine right ventricle. Circ Res 44: 309–315
Dhainaut J-F (1988) Evaluation and clinical applications of right ventricular performance monitoring in the ICU. Appl Cardiopulm Physiol 2: 47–57
Guyton AC (1967) Regulation of cardiac output. N Engl J Med 277: 805–12
Smiseth OA, Refsum A, Tyberg JV (1984) Pericardial pressure assessed by right atrial pressure: A basis for calculation of left ventricular transmural pressure. Am Heart J 108: 603–5
Guyton RA, Chiavarelli M, Padgett CA, Cheung EH, Staton GW, Hatcher CR Jr (1987) The influence of positive end-expiratory pressure on intrapericardial pressure and cardiac function after coronary artery bypass surgery. J Cardiothorac Anes 1 (2): 98–107
Guyton AC, Lindsey AW, Abernathy B, Richardson T (1957) Venous return at various right atrial pressures and the normal venous return curve. Am J Physiol 189: 609–15
Sibbald WJ, Driedger AA (1983) Right ventricular function in disease states: Pathologic considerations. Crit Care Med 11: 339–344
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 1991 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Pinsky, M.R. (1991). The Evaluation of Right Ventricular Function in Man. In: Dhainaut, JF., Payen, D. (eds) Strategy in Bedside Hemodynamic Monitoring. Update in Intensive Care and Emergency Medicine, vol 11. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-642-84167-5_5
Download citation
DOI: https://doi.org/10.1007/978-3-642-84167-5_5
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-52471-7
Online ISBN: 978-3-642-84167-5
eBook Packages: Springer Book Archive