[Right ventricular function in ARDS and mechanical respiration]

Abstract

The right ventricle is the stepchild of intensive care medicine. In diseases of the lung mainly when the relationship between ventilation and perfusion is disturbed, assisted respiration with positive end-expiratory pressure (PEEP) is essential to improve oxygenation. The serious damage to the lung parenchyma as seen in adult (acute) respiratory distress syndrome (ARDS) and pneumonia has considerable consequences for cardiac function. Whereas left ventricular function remains almost completely unaffected well into late stages of the disease, the right ventricle is subjected early to stress from the underlying disease and mechanical ventilation. The effects of therapeutic measures aimed at maintaining oxygenation and ventilation partially have negative consequences for right ventricular function and encourage the development of acute cor pulmonale. They can be the cause of right-sided heart failure.