Changes in Muscle Sympathetic Nerve Activity, Venous Plasma Catecholamines, and Calf Vascular Resistance during Mechanical Ventilation with PEEP in Humans

Selldén, Hans; Sjövall, Henrik; Wallin, B. Gunnar; Häggendal, Jan; Ricksten, Sven‐Erik

doi:10.1097/00000542-198902000-00011

Cited by 29 publications

(22 citation statements)

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“…I n the present study baro-and lung receptor reflexes were elicited with ventilator-induced sighs, PEEP and a valsalva-like manoeuvre. All three manoeuvres reduce blood pressure and/or unload low pressure baroreceptors, which in the awake state increases MSA (27,28). MSA-responses were similar during light anaesthesia, but with increasing anaesthetic depth the effects on MSA declined, presumably due to decreased reflex sensitivity.…”

Section: Baroreceptor And/or Lung Receptor Reflex Effectsmentioning

confidence: 91%

Characteristics of muscle nerve sympathetic activity during general anaesthesia in humans

Sellgren

Pontén

Wallin

1992

Acta Anaesthesiol Scand

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General anaesthesia influences the cardiovascular system at different levels. To increase our knowledge of how sympathetic outflow is affected by anaesthetic interventions, we used direct microelectrode recordings of muscle sympathetic activity (MSA) in the peroneal nerve in 18 patients scheduled for ENT-surgery. During induction of anaesthesia (propofol 2.1 mg/kg or methohexitone 1.4 mg/kg), all patients showed reductions in MSA (from 41 +/- 4 to 20 +/- 4 bursts/min). With endotracheal intubation there was a sudden increase of activity and in several patients the normal pulse-synchrony of MSA was lost temporarily. Maintenance of anaesthesia with nitrous oxide (n = 12) increased MSA and methohexitone (n = 2), propofol (n = 3) and isoflurane (n = 8) decreased MSA, while the effect of halothane (n = 3) varied. Baroreflex mechanisms were still operative but seemed to be depressed in relation to anaesthetic agent and depth. Laryngeal and surgical stimuli caused increases in MSA and blood pressure, lasting several minutes after the stimulation. It is concluded that the strength of MSA is profoundly influenced by the choice of anaesthetic agent. A suppression of activity is more common than an increase. Qualitatively, several sympathetic reflexes operate in a similar way during light anaesthesia as in awake subjects, but are depressed or absent during deep anaesthesia.

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Section: Baroreceptor And/or Lung Receptor Reflex Effectsmentioning

confidence: 91%

Characteristics of muscle nerve sympathetic activity during general anaesthesia in humans

Sellgren

Pontén

Wallin

1992

Acta Anaesthesiol Scand

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“…tory pressure, PEEP, ventilation. In man, PEEP-induced increases in muscle sympathetic nerve activity correlated with concomitant increases in venous plasma NE concentrations (14). An increase in both total body and mesenteric endogenous NE spillover in response to PEEP has been reported in the pig (15).…”

mentioning

confidence: 89%

“…Hemodynamic alterations produced by PEEP ventilation include induced decreases in cardiac output and reflex regional vasoconstriction (14)(15)(16)(17)(18)(19)(20)(21). The intensity of vasoconstrictor responses, reported from both clinical and experimental studies, vary among vascular beds (14,(17)(18)(19)(20)(21), but seem to reflect an increase in overall sympathetic discharge.…”

mentioning

confidence: 99%

Systemic levels and preportal organ release of tissue‐type plasminogen activator are enhanced by PEEP in the pig

Seeman-Lodding

Häggmark

Jern

et al. 1999

Acta Anaesthesiol Scand

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“…It has to be acknowledged, however, that, in contrast to MSNA, HRV has limited utility when changes in autonomic outflow due to unloading of low-pressure cardiopulmonary baroreceptors are investigated (14). These receptors, which are located in the atria, ventricles, and pulmonary veins, are unloaded by a reduction in venous return and/or lowering of cardiac filling pressure even in the absence of significant changes in SV or CO (35,46).…”

Section: Interpretation Of Changes In Hrvmentioning

confidence: 99%

Heart rate variability and spontaneous baroreflex sequences in supine healthy volunteers subjected to nasal positive airway pressure

Valipour¹,

Schneider²,

Kössler³

et al. 2005

Journal of Applied Physiology

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. Heart rate variability and spontaneous baroreflex sequences in supine healthy volunteers subjected to nasal positive airway pressure. J Appl Physiol 99: [2137][2138][2139][2140][2141][2142][2143] 2005. First published July 7, 2005; doi:10.1152/japplphysiol.00003.2005.-To determine the dynamic effects of short-term nasal positive airway pressure (nPAP) on cardiovascular autonomic control, continuous recordings of noninvasively obtained hemodynamic measurements and heart rate variability (HRV) were obtained in 10 healthy subjects during frequency-controlled breathing (between 0.20 and 0.24 Hz) in supine posture under different pressures of nPAP ranging from 3 to 20 cmH 2O. HRV was assessed using spectral analysis of the R-R interval. The slope of the regression line between spontaneous systolic blood pressure and pulse interval changes was taken as an index of the sensitivity of arterial baroreflex modulation of heart rate (sequence method). Application of nPAP resulted in a pressure-dependent decrease of cardiac output and stroke volume (P Ͻ 0.05, ANOVA) and in an increase in total peripheral resistance (P Ͻ 0.03, ANOVA). Hemodynamic changes under increasing nPAP were accompanied by a decrease in total power of HRV despite mean R-R interval remaining unchanged. The overall decrease in HRV was accompanied by a reduction across all frequency bands when absolute units were used (P Ͻ 0.01). When the power of low frequency and high frequency was calculated in normalized units, a diminished high frequency and an increased low-to-high frequency ratio were observed (P Ͻ 0.05). Compared with low levels of nPAP, pressure levels of Ͼ10 cmH 2O were associated with a significant decline in the mean slope of spontaneous baroreceptor sequences (P Ͻ 0.04). These findings indicate that short-term administration of nPAP in normal subjects exerts significant alterations in R-R interval variability and spontaneous baroreflex modulation of heart rate. cardiac output; cardiovascular autonomic control; heart-lung interaction RESPIRATION SIGNIFICANTLY INFLUENCES autonomic cardiovascular control (12). During normal breathing, oscillatory changes of left ventricular stroke volume (SV) and arterial blood pressure (BP) are sensed by baroreceptors, which provoke parallel R-R interval changes by means of baroreflex physiology (27). Hemodynamic oscillations during normal (negative pressure) respiration are predominantly due to changes in intrathoracic pressure (ITP) (30). However, little is known about the effects of augmented positive ITP, which occurs with positive airway pressure (PAP) ventilation, on cardiovascular autonomic control. The application of PAP, both invasively or noninvasively, increases ITP and may result in a reduction in cardiac filling pressures (23,29,37,43). A reduction in cardiac filling pressures associated with PAP (or positive end-expiratory pressure) may induce a compensatory increase in vascular resistance to maintain systemic arterial pressure in the face of a reduced cardiac output (CO) (5, 41). The increase in...

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Changes in Muscle Sympathetic Nerve Activity, Venous Plasma Catecholamines, and Calf Vascular Resistance during Mechanical Ventilation with PEEP in Humans

Cited by 29 publications

References 0 publications

Characteristics of muscle nerve sympathetic activity during general anaesthesia in humans

Characteristics of muscle nerve sympathetic activity during general anaesthesia in humans

Systemic levels and preportal organ release of tissue‐type plasminogen activator are enhanced by PEEP in the pig

Heart rate variability and spontaneous baroreflex sequences in supine healthy volunteers subjected to nasal positive airway pressure

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