{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,16]],"date-time":"2026-10-16T15:56:01Z","timestamp":1792166161708,"version":"4.4.0"},"reference-count":83,"publisher":"American Physiological Society","issue":"5","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Journal of Applied Physiology"],"published-print":{"date-parts":[[2019,11,1]]},"abstract":"<jats:p>\n                    The objective of this minireview is to describe the physiology and potential clinical benefits derived from inspiration. Recent animal and clinical studies demonstrate that one of the body\u2019s natural mechanisms associated with inspiration is to harness the respiratory pump to enhance circulation to vital organs. There is evidence that large reductions in intrathoracic pressure (&gt;20 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O) caused by some inspiration maneuvers (e.g., Mueller maneuver) or pathophysiology (e.g., heart failure, chronic obstructive lung disease) can result in adverse hemodynamic effects. However, the respiratory pump can improve cardiovascular functions when a \u201csweet spot\u201d for generation of negative intrathoracic pressure during inspiration can be maintained at or less than 10 cmH\n                    <jats:sub>2<\/jats:sub>\n                    O below normal inspiration. These beneficial physiological effects include greater cardiac filling and output, lower intracranial pressure, cardiac baroreflex resetting, greater cerebral blood flow oscillatory patterns, increased vascular pressure gradients, and promoting sustained feedback between sympathetic nerve activity and arterial pressure. In addition to promoting gas exchange, data obtained from numerous animal and human experiments have provided new insights into \u201cthe other side of breathing\u201d: the modulation of circulation by reduced intrathoracic pressure generated during inspiration. The translation of these physiological relationships form the basis for the development and application of technologies designed to optimize the intrathoracic pump for treatment of clinical conditions associated with hypovolemia including cardiac arrest, orthostatic hypotension, hemorrhagic shock, and traumatic brain injury. Harnessing these fundamental mechanisms that control cardiopulmonary physiology provides opportunities to use inspiration as a potential tool to help treat significant and often life-threatening circulatory disorders.\n                  <\/jats:p>","DOI":"10.1152\/japplphysiol.00050.2019","type":"journal-article","created":{"date-parts":[[2019,6,21]],"date-time":"2019-06-21T16:18:50Z","timestamp":1561133930000},"page":"1187-1196","source":"Crossref","is-referenced-by-count":40,"title":["Mechanisms of inspiration that modulate cardiovascular control: the other side of breathing"],"prefix":"10.1152","volume":"127","author":[{"given":"Victor A.","family":"Convertino","sequence":"first","affiliation":[{"name":"Battlefield Health & Trauma Center for Human Integrative Physiology, U.S. Army Institute of Surgical Research, JBSA Fort Sam Houston, Texas"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"24","reference":[{"key":"B1","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000246013.47237.86"},{"key":"B2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.108.799940"},{"key":"B3","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.3.2.210"},{"key":"B4","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1996.81.1.7"},{"key":"B5","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM197908303010901"},{"key":"B6","first-page":"13","volume":"14","author":"Butler FK","year":"2014","journal-title":"J Spec Oper Med"},{"key":"B7","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1974.sp010673"},{"key":"B8","doi-asserted-by":"publisher","DOI":"10.1113\/EP086654"},{"key":"B9","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.76.5.1020"},{"key":"B10","doi-asserted-by":"publisher","DOI":"10.1186\/s13049-017-0450-5"},{"key":"B11","doi-asserted-by":"publisher","DOI":"10.3357\/ASEM.3204.2012"},{"key":"B12","first-page":"2","volume":"39","author":"Convertino VA","year":"2014","journal-title":"JEMS"},{"key":"B13","first-page":"319","volume":"76","author":"Convertino VA","year":"2005","journal-title":"Aviat Space Environ Med"},{"key":"B14","first-page":"P55","volume":"12","author":"Convertino VA","year":"2005","journal-title":"J Gravit Physiol"},{"key":"B15","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0b013e3182606124"},{"key":"B16","doi-asserted-by":"publisher","DOI":"10.1007\/s00421-005-1344-1"},{"key":"B17","first-page":"486","volume":"77","author":"Convertino VA","year":"2006","journal-title":"Aviat Space Environ Med"},{"key":"B18","doi-asserted-by":"publisher","DOI":"10.1007\/s10286-004-0180-4"},{"key":"B19","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000134348.69165.15"},{"key":"B20","doi-asserted-by":"publisher","DOI":"10.3357\/ASEM.2598.2009"},{"key":"B21","first-page":"P27","volume":"17","author":"Convertino VA","year":"2010","journal-title":"J Gravit Physiol"},{"key":"B22","doi-asserted-by":"publisher","DOI":"10.1097\/01.CCM.0000259464.83188.2C"},{"key":"B23","doi-asserted-by":"publisher","DOI":"10.4187\/respcare.01018"},{"key":"B24","doi-asserted-by":"publisher","DOI":"10.1097\/01.ta.0000221348.82115.a2"},{"key":"B25","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.2009.177352"},{"key":"B26","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.01155.2003"},{"key":"B27","doi-asserted-by":"publisher","DOI":"10.1016\/0034-5687(81)90111-0"},{"key":"B28","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCEP.114.002605"},{"key":"B29","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00006.2018"},{"key":"B30","doi-asserted-by":"publisher","DOI":"10.1161\/01.RES.56.1.20"},{"key":"B31","doi-asserted-by":"publisher","DOI":"10.1152\/ajplegacy.1957.189.3.609"},{"key":"B32","doi-asserted-by":"publisher","DOI":"10.1016\/j.cnur.2017.01.010"},{"key":"B33","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2012.10.049"},{"key":"B34","doi-asserted-by":"publisher","DOI":"10.1097\/SHK.0b013e3181f7d92b"},{"key":"B35","doi-asserted-by":"publisher","DOI":"10.1016\/0002-8703(88)90618-7"},{"key":"B36","doi-asserted-by":"publisher","DOI":"10.1113\/jphysiol.1993.sp019483"},{"key":"B37","unstructured":"Institute of Medicine Committee on Fluid Resuscitation for Combat Casualties. 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