Clinical review: Guyton - the role of mean circulatory filling pressure and right atrial pressure in controlling cardiac output |
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Authors: | William R Henderson Donald EG Griesdale Keith R Walley A William William Sheel |
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Affiliation: | 1Critical Care Medicine, Vancouver General Hospital, ICU, JPPN, 2nd Floor, Room 2438, 899 West 12th Avenue, Vancouver, BC, V5Z 1M9, Canada;2Heart + Lung Institute, St. Paul''s Hospital, Room 166, 1081 Burrard Street, Vancouver, BC, V6Z 1Y6, Canada;3Health and Integrative Physiology Lab, Osborne Ctr Unit II - Room 208, School of Human Kinetics, 210 - 6081 University Boulevard, Vancouver, BC, V6T 1Z1, Canada |
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Abstract: | Arthur Guyton's concepts of the determinative role of right heart filling in cardiac output continue to be controversial. This paper reviews his seminal experiments in detail and clarifies the often confusing concepts underpinning his model. One primary criticism of Guyton's model is that the parameters describing venous return had not been measured in a functioning cardiovascular system in humans. Thus, concerns have been expressed in regard to the ability of Guyton's simplistic model, with few parameters, to model the complex human circulation. Further concerns have been raised in regard to the artificial experimental preparations that Guyton used. Recently reported measurements in humans support Guyton's theoretical and animal work. |
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