With which of the following pressures does the therapist need to be most concerned regarding the effects of positive-pressure breathing on the cardiovascular system during mechanical ventilation?
A. alveolar pressure
B. airway pressure
C. pleural pressure
D. transairway pressure
?ANS: C
A. Incorrect response: Alveolar pressure is often represented by the plateau, or static, pressure. It is also called the alveolar distending pressure and is used in the calculation of static compliance.
B. Incorrect response: The airway pressure is usually measured in the ventilator breathing circuit.
C. Correct response: Pleural pressure, estimated by esophageal pressure, is the pressure in the pleural space. During spontaneous breathing, pleural pressure is always subatmospheric. However, during positive-pressure mechanical ventilation, pleural pressure becomes supra-atmospheric. Because of its proximity to the major cardiovascular structures (heart, pulmonary circulation vena cava, and aorta), pleural pressure closely reflects the impact imposed by positive-pressure breathing on blood flow.
D. Incorrect response: Transairway pressure is the pressure gradient responsible for the flow of air into and out of the lungs.
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