Letter to the editor: Comments on “Value and determinants of the mean systemic filling pressure in critically ill patients”

Brengelmann, G. L.

doi:10.1152/ajpheart.00613.2015

Cited by 8 publications

(2 citation statements)

References 7 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Levy interpreted RAP solely as consequence of altered flow (33). This opposite interpretation of cause and effect from Guyton could not be resolved in an ongoing theoretical debate (13)(14)(15)40,(48)(49)(50)52,(57)(58)(59)(60)(61)(62)(63)(64). We have recently performed a porcine experiment without starling resistors and with a complete heart bypass and ligation of the pulmonary artery to get full control of the pump and volume shifts due to lung inflation.…”

Section: Msfp Seems To Be Constant Between Species (35)mentioning

confidence: 99%

“…Critics argue that a pressure defined for circulatory standstill cannot be present within an ongoing circulation and its exact location in the vasculature would be unknown. Further, such pressures could by no means drive flow at steady state (13,14,48,49), because emptying would decrease the pressure without constant refill. These critics ignore that the emptying mechanics including a highly elastic venous reservoir, are central for the achievable flow (44,50).…”

mentioning

confidence: 99%

See 1 more Smart Citation

Determinants of systemic venous return and the impact of positive pressure ventilation

Berger¹,

Takala²

2018

Ann. Transl. Med.

View full text Add to dashboard Cite

Venous return, i.e., the blood flowing back to the heart, is driven by the pressure difference between mean systemic filling pressure and right atrial pressure (RAP). Besides cardiac function, it is the major determinant of cardiac output. Mean systemic filling pressure is a function of the vascular volume. The concept of venous return has a central role for heart lung interactions and the explanation of shock states.Mechanical ventilation during anaesthesia and critical illness may severely affect venous return by different mechanisms. In the first part of the following article, we will discuss the development of the concept of venous return, its specific components mean systemic and mean circulatory filling pressure (MCFP), RAP and resistance to venous return (RVR). We show how these pressures relate to the volume state of the circulation. Various interpretations and critiques are elucidated. In the second part, we focus on the impact of positive pressure ventilation on venous return and its components, including latest results from latest research.

show abstract