心肺交互作用(simplified).pptVIP

XIQI the interaction of venous return curve (upper left) and cardiac function curve (upper right) define the ‘working’ cardiac output, venous return and right atrial pressure (Pra) values Guyton AC. Determination of cardiac output by equating venous return curves with cardiac response curves. Physiol Rev 1955; 35:123 –129. For example 患者：中度肺疾病，PEEP=20 cmH2O Ppl可能增加8 cm H2O（ 约7 mmHg） 相对于大气压 CVP =15 mmHg 室壁膨胀压=8 mmHg For example 心脏水平外周毛细血管压=15 mmHg 正常外周静脉回心阻力=4 – 8 mmHg 外周静脉静水压=19– 23 mmHg 净液体滤过到组织间隙 背侧毛细血管额外静水压平均值= 7 cm 该部位外周静脉静水压=26–30mmHg 高的心脏充盈压可能增加高PEEP患者CO 代价：血管内血浆液体渗出增加 Model of