Respiration in cardiovascular regulation models: Signal or confounding factor? A review

The coupling of breathing and cardiovascular (CV) regulation is a main source of spontaneous short term CV variability signals. However, intense interaction with short term regulations involving baroreflex, vasomotion, and central drives and the ubiquitous presence of respiratory driven/modulated responses may render it a potent confounding factor, when not properly described. Major challenges are found in the acute clinical environment, e.g. ICU and OR, where monitoring cardiorespiratory coupling and CV regulation is of high impact, while sedation and forced ventilation extensively change the reflex portrait. A review is here attempted, finalized to approach ICU recordings in the ShockOmics EC project, aimed at integrating biomolecular and CV data in acute shock, under diffuse receptor cleavage and autonomic impairment.