Understanding Heart-Lung Interactions: Concepts of Fluid Responsiveness

Abstract

AbstractThis chapter focuses on the impact of fluid administration and ventilation on hemodynamics in critically ill patients. The chapter emphasizes the importance of determining fluid responsiveness before administering fluids to avoid volume overload, which can lead to increased morbidity and mortality. The parameters for predicting fluid responsiveness are based on cyclic variations in respiration on cardiac filling and require an understanding of heart-lung interactions. The chapter discusses the basics of respiratory and cardio-circulatory physiology, including the two components of the cardiovascular system (the circuit and pump), and how they are affected by transmural pressure. It will discuss the different functional hemodynamic monitoring tools with their indications and pitfalls. A thorough understanding of the effects of spontaneous and positive pressure ventilation on the cardiovascular system is important for anticipating and predicting hemodynamic effects after fluid administration and developing strategies to avoid or treat fluid infusion-related complications.