Abstract
Mean systemic filling pressure (P sf) is an indicator of the filling state of the systemic circulation. Cardiac output (Q′) is related linearly to the difference betweenP sf and central venous pressure (P cv), according to:Q′ = (P sf −P cv)/R sf, whereR sf is the flow resistance downstream from the sites where blood pressure is equal toP sf In 16 anaesthetized pigs we evaluatedP sf,R sf andQ′ during baseline conditions, continuous endotoxin infusion and after subsequent fluid loading.P sf andR sf were determined from simultaneous measurements ofQ′ andP cv at seven levels of lung inflation. The following results were obtained.P sf was 8.1 ±1.8 mm Hg (mean ± SD) during baseline conditions, increased after endotoxin infusion to 9.9 ± 3.2 mm Hg (P = 0.04) and remained the same after infusion of 18 ml · kg−1 of Ringer's lactate.R sf increased from 0.34 ± 0.07 to 0.80 ± 0.34 mm Hg · ml−1 · s by endotoxin and decreased after fluid infusion to 0.58 ± 0.14.Q′ changed inversely proportional toR sf (P = 0.001).R sf changes were highly correlated with the changes in total systemic flow resistance (R S) (P < 0.001). Endotoxin caused haemoconcentration and a decrease in plasma volume. The stability ofP sf during endotoxin infusion and after volume loading indicate that the stressed volume was well maintained and changes in blood volume are compensated by changes in nonstressed volume. The increase inR sf can be attributed to arteriolar vasoconstriction, venous vasoconstriction and haemoconcentration.
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Hiesmayr, M., Jansen, J.R.C. & Versprille, A. Effects of endotoxin infusion on mean systemic filling pressure and flow resistance to venous return. Pflugers Arch. 431, 741–747 (1996). https://doi.org/10.1007/BF02253838
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DOI: https://doi.org/10.1007/BF02253838