ABSTRACT
The first edition of this chapter ( 1985) examined the mechanical similarities between the forces that generate airflow in and out of the lungs and those that generate blood flow in and out of the vasculature. A mathematical model was developed that could be solved for the steady-state cardiac output based on elastic and resistive properties of the peripheral circulation, functional characteristics of the heart, and pressures surrounding the heart and circulation, which are altered by ventilation or ventilatory maneuvers. Finally, available empirical data on hemodynamic effects of the Valsalva and Mueller maneuvers, cardiopulmonary resuscitation, and the therapeutic potential of manipulation of pleural pressure were analyzed in terms of the predictions of the mathematical model. We concluded: "We foresee a day when manipulation of pleural pressure will allow the support of the arrested or failing circulation in a manner analogous to the support of ventilatory failure in the modem intensive care unit."
