Preload changes by positive pressure ventilation can be used for assessment of left ventricular systolic function
2003 (English)In: Acta Anaesthesiol Scand, Vol. 47, no 5, 541-8 p.Article in journal (Refereed) Published
BACKGROUND: Assessment of preload independent left ventricular function with conductance volumetry is traditionally accomplished by inflating a balloon in the inferior caval vein. Our aim was to investigate if a similar change in preload could be achieved by positive pressure ventilation with large tidal volume. METHODS: Conductance volumetry generating left ventricular pressure-volume loops was used in seven pentobarbital-anesthetized pigs. Changes in preload recruitable stroke work were studied, comparing the effects of inferior vena cava occlusion (IVCO) or large tidal volume (LTV). Cardiodepression was induced by halothane anesthesia and halothane + phenylephrine, and stimulation by epinephrine infusion. RESULTS: Although the decreasis in left ventricular end diastolic volume was slightly less with LTV (16.5 +/- 1.7 ml, mean +/- SEM) than with IVCO (22.4 +/- 1.7 ml) (P < 0.0001) the PRSW-slopes showed a high degree of correlation (r=0.80, P < 0.0001). Although peak tracheal pressures increased significantly to 27.8 +/- 0.9 mmHg during LTV, esophageal pressures (used as an indicator of pericardial pressure) were unchanged. CONCLUSIONS: Positive pressure ventilation with LTV is similar to IVCO in creating transient changes in preload, necessary for assessment of left ventricular systolic function. This observation was valid also during drug-induced cardiac depression and stimulation. The preload recruitable stroke work used for this validation was shown to be a reliable and stable method.
Place, publisher, year, edition, pages
2003. Vol. 47, no 5, 541-8 p.
Anesthetics, Inhalation/pharmacology, Animals, Blood Pressure/physiology, Esophagus/physiology, Female, Halothane/pharmacology, Phenylephrine/pharmacology, *Positive-Pressure Respiration, Stroke Volume/physiology, Swine, Thermodilution, Tidal Volume/physiology, Trachea/physiology, Vasoconstrictor Agents/pharmacology, Vena Cava, Inferior/physiology, Ventricular Function, Left/*physiology
IdentifiersURN: urn:nbn:se:umu:diva-31404ISBN: 0001-5172 (Print)OAI: oai:DiVA.org:umu-31404DiVA: diva2:292964
Sellgren, J Soderstrom, S Johansson, G Biber, B Haggmark, S Ponten, J Research Support, Non-U.S. Gov't Denmark Acta anaesthesiologica Scandinavica Acta Anaesthesiol Scand. 2003 May;47(5):541-8.2010-02-102010-02-102015-09-15