Skip to Main content Skip to Navigation
Journal articles

Breathing cardiovascular variability and baroreflex in mechanically ventilated patients

Abstract : Heart rate and blood pressure variations during spontaneous ventilation are related to the negative airway pressure during inspiration. Inspiratory airway pressure is positive during mechanical ventilation, suggesting that reversal of the normal baroreflex-mediated pattern of variability may occur. We investigated heart rate and blood pressure variability and baroreflex sensitivity in 17 mechanically ventilated patients. ECG (RR intervals), invasive systolic blood pressure (SBP), and respiratory flow signals were recorded. High-frequency (HF) amplitude of RR and SBP time series and HF phase differences between RR, SBP, and ventilatory signals were continuously computed by Complex DeModulation (CDM). Cross-spectral analysis was used to assess the coherence and the gain functions between RR and SBP, yielding baroreflex sensitivity indices. The HF phase difference between SBP and ventilatory signals was nearly constant in all patients with inversion of SBP variability during the ventilator cycle compared with cycling with negative inspiratory pressure to replicate spontaneous breathing. In 12 patients (group 1), the phase difference between RR and ventilatory signals changed over time and the HF-RR amplitude varied. In the remaining five patients (group 2), RR-ventilatory signal phase and HF-RR amplitude showed little change; however, only one of these patients exhibited a RR-ventilatory signal phase difference mimicking the normal pattern of respiratory sinus arrhythmia. Spectral coherence between RR and SBP was lower in the group with phase difference changes. Positive pressure ventilation exerts mainly a mechanical effect on SBP, whereas its influence on HR variability seems more complex, suggesting a role for neural influences. Copyright © 2008 the American Physiological Society.
Document type :
Journal articles
Complete list of metadatas

https://hal-univ-evry.archives-ouvertes.fr/hal-02489936
Contributor : Univ Évry Hal <>
Submitted on : Monday, February 24, 2020 - 5:40:23 PM
Last modification on : Thursday, September 3, 2020 - 1:06:40 PM

Links full text

Identifiers

Collections

Citation

A. van de Louw, C. Médigue, Y. Papelier, F. Cottin. Breathing cardiovascular variability and baroreflex in mechanically ventilated patients. American Journal of Physiology - Regulatory Integrative and Comparative Physiology, 2008, 295 (6), pp.R1934-R1940. ⟨10.1152/ajpregu.90475.2008⟩. ⟨hal-02489936⟩

Share

Metrics

Record views

41