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Related to intrathoracic pressure: intrapleural pressure
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Elevated PPV and SVV cut-off values for discriminating fluid responsiveness might be expected under conditions of pneumoperitoneum combined with steep Trendelenburg position, because elevated intra-abdominal pressure shifts the diaphragm cephalad, leading to increased intrathoracic pressure and stiffened abdominal part of the chest wall (27).
With spontaneous ventilation, there is a reduction in intrathoracic pressure during inspiration and a subsequent decrease in pulmonary vascular pressure (Swan, 1991).
Effect of intrathoracic pressure on left ventricular performance.
Inspiratory effort and swings in intrathoracic pressure vary to a greater extent with each breath.
Cerebral perfusion is compromised due to increases in jugular venous pressure caused by high intrathoracic pressure impeding venous return from the brain.
The increase in wedge pressure can be explained by an increase in intrathoracic pressure caused by the displacement of the diaphragm during the body tilt (7), which, in this patient's case, also caused her to experience difficulty in breathing, which was not at all conducive to her recovery.
PEEP is commonly used and is effective in the management of hypoxia secondary to alveolar capillary leak and ventilation perfusion mismatch by increasing intrathoracic pressure and improving arterial oxygenation.
The model assumes compression of the cerebral capillary bed by transmission of changes of intrathoracic pressure associated with ventilation.
Intrathoracic pressure and pulmonary vascular resistance may increase due to hyperinflation and hypoxemia, which leads to a rising pulsus paradoxus (National Institute of Health, 1991).
In addition, intrathoracic pressure swings strain the heart and great vessels.
The greater the nasal resistance, the greater the negative intrathoracic pressure needed for inspiration.
Besides, the high negative intrathoracic pressure caused by airway closure acts on the airway mucosa increases its sensitivity and results in more asthma attacks.