PPV May Be a Starting Point to Achieve Circulatory Protective Mechanical Ventilation

Pulse pressure variation (PPV) is a mandatory index for hemodynamic monitoring during mechanical ventilation. The changes in pleural pressure (Ppl) and transpulmonary pressure (PL) caused by mechanical ventilation are the basis for PPV and lead to the effect of blood flow. If the state of hypovolemi...

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Autores principales:	Longxiang Su, Pan Pan, Huaiwu He, Dawei Liu, Yun Long
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	pulse pressure variation mechanical ventilation cardiopulmonary interactions circulatory-protection blood flow Medicine (General) R5-920
Acceso en línea:	https://doaj.org/article/06637c20e9304c539e66abd773557cda
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spelling	oai:doaj.org-article:06637c20e9304c539e66abd773557cda2021-12-02T09:21:39ZPPV May Be a Starting Point to Achieve Circulatory Protective Mechanical Ventilation2296-858X10.3389/fmed.2021.745164https://doaj.org/article/06637c20e9304c539e66abd773557cda2021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fmed.2021.745164/fullhttps://doaj.org/toc/2296-858XPulse pressure variation (PPV) is a mandatory index for hemodynamic monitoring during mechanical ventilation. The changes in pleural pressure (Ppl) and transpulmonary pressure (PL) caused by mechanical ventilation are the basis for PPV and lead to the effect of blood flow. If the state of hypovolemia exists, the effect of the increased Ppl during mechanical ventilation on the right ventricular preload will mainly affect the cardiac output, resulting in a positive PPV. However, PL is more influenced by the change in alveolar pressure, which produces an increase in right heart overload, resulting in high PPV. In particular, if spontaneous breathing is strong, the transvascular pressure will be extremely high, which may lead to the promotion of alveolar flooding and increased RV flow. Asynchronous breathing and mediastinal swing may damage the pulmonary circulation and right heart function. Therefore, according to the principle of PPV, a high PPV can be incorporated into the whole respiratory treatment process to monitor the mechanical ventilation cycle damage/protection regardless of the controlled ventilation or spontaneous breathing. Through the monitoring of PPV, the circulation-protective ventilation can be guided at bedside in real time by PPV.Longxiang SuPan PanHuaiwu HeDawei LiuYun LongFrontiers Media S.A.articlepulse pressure variationmechanical ventilationcardiopulmonary interactionscirculatory-protectionblood flowMedicine (General)R5-920ENFrontiers in Medicine, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	pulse pressure variation mechanical ventilation cardiopulmonary interactions circulatory-protection blood flow Medicine (General) R5-920
spellingShingle	pulse pressure variation mechanical ventilation cardiopulmonary interactions circulatory-protection blood flow Medicine (General) R5-920 Longxiang Su Pan Pan Huaiwu He Dawei Liu Yun Long PPV May Be a Starting Point to Achieve Circulatory Protective Mechanical Ventilation
description	Pulse pressure variation (PPV) is a mandatory index for hemodynamic monitoring during mechanical ventilation. The changes in pleural pressure (Ppl) and transpulmonary pressure (PL) caused by mechanical ventilation are the basis for PPV and lead to the effect of blood flow. If the state of hypovolemia exists, the effect of the increased Ppl during mechanical ventilation on the right ventricular preload will mainly affect the cardiac output, resulting in a positive PPV. However, PL is more influenced by the change in alveolar pressure, which produces an increase in right heart overload, resulting in high PPV. In particular, if spontaneous breathing is strong, the transvascular pressure will be extremely high, which may lead to the promotion of alveolar flooding and increased RV flow. Asynchronous breathing and mediastinal swing may damage the pulmonary circulation and right heart function. Therefore, according to the principle of PPV, a high PPV can be incorporated into the whole respiratory treatment process to monitor the mechanical ventilation cycle damage/protection regardless of the controlled ventilation or spontaneous breathing. Through the monitoring of PPV, the circulation-protective ventilation can be guided at bedside in real time by PPV.
format	article
author	Longxiang Su Pan Pan Huaiwu He Dawei Liu Yun Long
author_facet	Longxiang Su Pan Pan Huaiwu He Dawei Liu Yun Long
author_sort	Longxiang Su
title	PPV May Be a Starting Point to Achieve Circulatory Protective Mechanical Ventilation
title_short	PPV May Be a Starting Point to Achieve Circulatory Protective Mechanical Ventilation
title_full	PPV May Be a Starting Point to Achieve Circulatory Protective Mechanical Ventilation
title_fullStr	PPV May Be a Starting Point to Achieve Circulatory Protective Mechanical Ventilation
title_full_unstemmed	PPV May Be a Starting Point to Achieve Circulatory Protective Mechanical Ventilation
title_sort	ppv may be a starting point to achieve circulatory protective mechanical ventilation
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/06637c20e9304c539e66abd773557cda
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PPV May Be a Starting Point to Achieve Circulatory Protective Mechanical Ventilation

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