OpenTube

How Mechanical Ventilation Affects Hemodynamics and Cardiac Output Explained

WBM Emergency & Critical Care

15,265 views

Mechanical ventilation can significantly affect hemodynamics, venous return, preload, afterload, right ventricular function, left ventricular function, cardiac output, and blood pressure. In this video, we review the hemodynamic effects of mechanical ventilation, focusing on how positive pressure ventilation changes intrathoracic pressure, cardiopulmonary interactions, ventricular loading conditions, and circulation.

Topics covered include:
• How mechanical ventilation affects hemodynamics
• Positive pressure ventilation and intrathoracic pressure
• Venous return and preload
• Right ventricular preload and afterload
• Pulmonary vascular resistance
• Left ventricular preload and afterload
• Cardiac output and blood pressure
• Effects of PEEP on circulation
• Hypotension after intubation
• Heart-lung interactions
• Mechanical ventilation in shock
• Mechanical ventilation in heart failure
• Bedside interpretation of hemodynamic changes
• Practical ICU and emergency medicine applications

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This content is intended for educational purposes only and should not be used as a substitute for clinical judgment, institutional protocols, specialist consultation, or individualized patient care.
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#MechanicalVentilation
#Hemodynamics
#CardiacOutput
#CriticalCare
#MedicalEducation

14 Comments

@WBMECC Creator 5 years ago (edited) Pinned

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@lindsaylebaron819 4 years ago

Respiratory therapist student here! Thanks for the video

@erniefoster4222 5 years ago

That brings me right back to my days of studying gas and fluid flow in pipes in Physics class 55yrs ago.
I'm glad you wrote the formula showing flow proportional to radius to the power of 4. That means a very small change in radius has a very large effect on flow. I worked out way back then that a change in tube radius from 6 units to 7 units doubles the flow. That's a much greater effect than you would guess at first glance. Thanks for the brain stimulating video.

@paulelkins425 5 years ago

Very enlightening! I didn't know about the complexities that MV causes in relation to pressure changes for the heart/lungs. Makes me think about bringing back iron lungs to help expand the thoracic cavity to relieve some of those unnatural pressures upon inspiration. At least that where my mind went. :)

@Casmige 5 years ago

Thank you for this.

This is why mechanical ventilation is the treatment of last resort, it has an 80% mortality rate no matter how good of health a person is going into & being put on the process especially notwithstanding the caustic medically induced chemical cocktails ”Coma”.

@Dan-qx4vv 3 years ago

This is an awesome video

@latestlatest4760 5 years ago

Actually...the increase PVR initially increases the LV preload, and another effect of MV on the LV is that there is also a decrease in LV wall stress (not just aorta Compliance). Cheers

@giorgikartlelishvili 2 years ago

Thanks for the brilliant video ! im cardiac surgery masters student , whilst the high tidal volumes are increasing the total pulmonar vascular resistancce , does it mean that ICU can simply adjust mechanical ventilation settings to avoid the increase in right ventricle afterload , caused by high PVR. thanks again !

@bonniedunbar6717 5 years ago

Doctor, thousands of families have felt that loved ones on the Covid units were put on vents much to soon which eventually led to death. This is especially true if it was an older family member. Do you feel this rush to vent could have been avoided if not for the pandemic?

@brigittelalonde9567 11 months ago

Not sure I understand how increase intrathoracique pressure increase aortic compliance....wouldn't that pressure squeeze against the aorta?

@hondapilot 3 years ago

Just saw this video. Very helpful. Can you elaborate how positive pressure ventilation or PEEP decreases aortic transmural pressure. Thank you

@chimnaadumun9037 4 years ago

ultimately ,what happens to cardiac output during mechanical ventilation please

@davidmbeckmann 5 years ago

Very nice review! In dark moments I wonder about bringing back a modern equivalent of the iron lung for advanced CoVid. We could use CPAP for hypoxia support and they could talk and eat?