Assessment of cardiovascular volume status by transoesophageal echocardiography and dye dilution during cardiac surgery

Hinder, Frank; Poelaert, Jan; Schmidt, Christoph; Hoeft, Andreas; Möllhoff, T.; Loick, H. M.; Aken, Hugo Van

doi:10.1097/00003643-199811000-00003

Cited by 56 publications

(25 citation statements)

References 13 publications

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“…Transpulmonary thermodilution can be used to determine global end-diastolic volume (GEDV) and intrathoracic blood volume (ITBV) as preload parameters [8,9]. Cardiac volumes are considered superior in assessing CI responses to fluid loading, after cardiac surgery, even when changes in filling pressures that are independent of PEEP, are considered [1,3,4,8,[10][11][12][13][14][15][16][17][18][19]. These latter studies only included general cardiac or coronary artery surgery (CAS) patients.…”

Section: Introductionmentioning

confidence: 99%

Relative value of pressures and volumes in assessing fluid responsiveness after valvular and coronary artery surgery

Breukers

Trof

Wilde

et al. 2009

European Journal of Cardio-Thoracic Surgery

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While volumes are equally useful in monitoring fluid responsiveness, the predictive and monitoring value of PAOP is greater after VS than after CAS. In contrast, the CVP is of similar value as volume measurements in monitoring fluid responsiveness after CAS. The different value of pressures rather than of volumes between surgery types is likely caused by systolic left ventricular dysfunction in VS. The study suggests an effect of systolic cardiac function on optimal parameters of fluid responsiveness and superiority of the pulmonary artery catheter over transpulmonary dilution, for haemodynamic monitoring of VS patients.

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Section: Introductionmentioning

confidence: 99%

Relative value of pressures and volumes in assessing fluid responsiveness after valvular and coronary artery surgery

Breukers

Trof

Wilde

et al. 2009

European Journal of Cardio-Thoracic Surgery

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“…Static indices measure one parameter at a set point of the ventilatory cycle and do not reliably predict VE responsiveness. 7,8 Dynamic indices measure the magnitude of a parameter's variation during a positive-pressure ventilatory cycle and accurately predict VE responsiveness. 9,10 The underlying concept is a biventricular functional assessment of the Frank-Starling curves, which permits the prediction of preload dependency.…”

mentioning

confidence: 99%

Impact of epinephrine and norepinephrine on two dynamic indices in a porcine hemorrhagic shock model

Giraud

Siegenthaler

Arroyo

et al. 2014

Journal of Trauma and Acute Care Surgery

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BACKGROUND: Pulse pressure variations (PPVs) and stroke volume variations (SVVs) are dynamic indices for predicting fluid responsiveness in intensive care unit patients. These hemodynamic markers underscore Frank-Starling law by which volume expansion increases cardiac output (CO). The aim of the present study was to evaluate the impact of the administration of catecholamines on PPV, SVV, and inferior vena cava flow (IVCF). METHODS:In this prospective, physiologic, animal study, hemodynamic parameters were measured in deeply sedated and mechanically ventilated pigs. Systemic hemodynamic and pressure-volume loops obtained by inferior vena cava occlusion were recorded. Measurements were collected during two conditions, that is, normovolemia and hypovolemia, generated by blood removal to obtain a mean arterial pressure value lower than 60 mm Hg. At each condition, CO, IVCF, SVV, and PPV were assessed by catheters and flow meters. Data were compared between the conditions normovolemia and hypovolemia before and after intravenous administrations of norepinephrine and epinephrine using a nonparametric Wilcoxon test. RESULTS:Eight pigs were anesthetized, mechanically ventilated, and equipped. Both norepinephrine and epinephrine significantly increased IVCF and decreased PPV and SVV, regardless of volemic conditions ( p G 0.05). However, epinephrine was also able to significantly increase CO regardless of volemic conditions. CONCLUSION: The present study demonstrates that intravenous administrations of norepinephrine and epinephrine increase IVCF, whatever the volemic conditions are. The concomitant decreases in PPV and SVV corroborate the fact that catecholamine administration recruits unstressed blood volume. In this regard, understanding a decrease in PPV and SVV values, after catecholamine administration, as an obvious indication of a restored volemia could be an outright misinterpretation. (J Trauma Acute Care Surg. 2014;77: 564Y569.

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“…cardiac filling pressures, and cardiological assessment, e.g. echocardiography, dye dilution [34] and thallium scanning [35], measurement of several plasma peptides has been reported to be useful for the assessment of cardiovascular volume status. These include fibronectin [36], adrenomedullin [37] and urodilantin [38], each of which may be as, or more, important than ANP as an indicator of cardiovascular volume status and asymptomatic cardiac failure, and of the regulation of the renal excretion of sodium and water after CPB.…”

Section: Discussionmentioning

confidence: 99%

Changes in calcitonin gene‐related peptide, atrial natriuretic peptide and brain natriuretic peptide in patients undergoing coronary artery bypass grafting

et al. 2003

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SummaryThe initiation of cardiopulmonary bypass creates significant derangements in cardiovascular volume status and both endocrine and autonomic nervous system function. To examine whether such derangements might differ in patients with different pre-operative physical status scores, we measured the plasma concentrations of calcitonin gene-related peptide, atrial natriuretic peptide and brain natriuretic peptide, catecholamines and antidiuretic hormone, as well as haemodynamic variables, during and after cardiopulmonary bypass in 27 consecutive patients undergoing coronary artery bypass grafting. The pre-operative levels of atrial natriuretic peptide and brain natriuretic peptide differed significantly between ASA II patients and III and IV patients [mean (SD) brain natriuretic peptide levels ¼ 14 (8.2) vs. 129 (51) pg.ml )1 ]. Plasma calcitonin gene-related peptide increased significantly in both groups after the initiation of cardiopulmonary bypass, and remained increased throughout cardiopulmonary bypass. The changes in plasma epinephrine, norepinephrine and antidiuretic hormone were similar to those reported previously. The changes in plasma calcitonin gene-related peptide, atrial natriuretic peptide and brain natriuretic peptide did not correlate with any changes in haemodynamic variables before or after cardiopulmonary bypass. Measurement of plasma brain natriuretic peptide might usefully be included in the pre-operative evaluation of patients with cardiac disease.

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Assessment of cardiovascular volume status by transoesophageal echocardiography and dye dilution during cardiac surgery

Cited by 56 publications

References 13 publications

Relative value of pressures and volumes in assessing fluid responsiveness after valvular and coronary artery surgery

Relative value of pressures and volumes in assessing fluid responsiveness after valvular and coronary artery surgery

Impact of epinephrine and norepinephrine on two dynamic indices in a porcine hemorrhagic shock model

Changes in calcitonin gene‐related peptide, atrial natriuretic peptide and brain natriuretic peptide in patients undergoing coronary artery bypass grafting

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