Positive Pressure & the Failing Heart 

Positive pressure ventilation is one of the most powerful tools we use at the bedside.

In this episode, I sit down with critical care cardiologist Willard Appelfeld, MD to unpack how positive pressure ventilation interacts with the failing heart. We break down preload, afterload, venous return, RV–LV interactions, and why CPAP, BiPAP, and invasive ventilation can dramatically improve patients with acute decompensated heart failure.

We move beyond dogma and into physiology—connecting ventilator settings to pulmonary edema. If you’ve ever wondered why positive NIPPV settings to flash pulmonary edema and how PPV affects the RV and LV.

 Cardiac mechanics Positive pressure as therapy Real ICU decision-making