Which of the following are potential effects of positive-pressure ventilation on the cardiovascular system? 1. Decreased venous return 2. Decreased cranial perfusion pressures 3. Increased pulmonary blood flow 4. Decreased ventricular stroke volume
a. 2 and 4 only
b. 1 and 4 only
c. 3 and 4 only
d. 1, 2, 3, and 4
ANS: B
Positive pleural pressure compresses the intrathoracic veins and increases central venous and right atrial filling pressures. As these pressures increase, venous return to the heart is impeded and right ventricular preload and stroke volume decrease, as does pulmonary blood flow.
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