Hemodynamic Changes During Prostatectomy in Cardiac Patients

Angelis, John De; Chang, Potter C.; Kaplan, Joseph; Kudish, Harold G.; Sacks, Stephen A.; Wender, Ronald H.; Bonwell, P.; Bluestone, D.

doi:10.1097/00132586-198210000-00055

Cited by 3 publications

(4 citation statements)

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“…Haemodynamic stress can occur from bladder irrigation with glycine solution, but is not always detecturethral prostatic operations (5,10). In the present study, an intravenous load of 3.3 to 4.4 1 of 1.5% glycine solution or isotonic saline was given to sheep with body weights similar to those of adult humans.…”

Section: Discussionmentioning

confidence: 91%

Haemodynamics and fluid balance after intravenous infusion of 1.5% glycine in sheep

Stalberg

Hahn

Hjelmqvist

et al. 1993

Acta Anaesthesiol Scand

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With the aim of studying the pathophysiological background of the "TUR syndrome", we gave six conscious ewes an intravenous infusion of 57 ml/kg of 1.5% glycine solution over 40 min. Isotonic saline infusions served as controls. Central haemodynamics were monitored. The plasma concentrations of protein, K, Na and vasopressin, and plasma osmolality were measured repeatedly for up to 4 h. The urinary excretions of Na, K and osmoles were also followed. Both infusions caused an elevation of the mean arterial pressure. With glycine, the pressure increased from 93 +/- 4 to 112 +/- 12 mmHg (12.4 +/- 0.5 to 14.9 +/- 1.6 kPa) (mean +/- s.d.). The pulmonary capillary wedge pressure increased from 7 +/- 3 to 16 +/- 3 mmHg (0.9 +/- 0.4 to 2.1 +/- 0.4 kPa) and remained slightly elevated. The central venous pressure rose from 2 +/- 3 to 11 +/- 3 mmHg (0.3 +/- 0.4 to 1.5 +/- 0.4 kPa) but returned to baseline within 30 min after the infusion. Infusion of glycine resulted in a decrease in the plasma Na concentration from 144 +/- 3 to 114 +/- 4 mmol/l. The plasma osmolality decreased from 290 +/- 2 to 280 +/- 1 mosmol/l, and remained low. There was a median 6-fold increase in plasma vasopressin concentration, while saline did not elicit vasopressin release. Despite the absence of electrolytes in glycine solution, the urinary excretion of sodium amounted to 106 +/- 40 mmol. We conclude that i.v. infusion of 1.5% glycine solution in sheep causes a transient circulatory strain and natriuresis. Moreover, a vasopressin-mediated reduction of maximal water excretion contributes to persisting hypoosmolality.

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Section: Discussionmentioning

confidence: 91%

Haemodynamics and fluid balance after intravenous infusion of 1.5% glycine in sheep

Stalberg

Hahn

Hjelmqvist

et al. 1993

Acta Anaesthesiol Scand

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“…The effects of TURP on the cardiovascular system of patients with severe cardiovascular disease are very com plex [8]. A rapid rise in preload, as a result of the autotransfusion of peripheral blood to the central circulation, augments cardiac work and wall tension and therefore oxygen demand.…”

Section: Discussionmentioning

confidence: 99%

“…A rapid rise in preload, as a result of the autotransfusion of peripheral blood to the central circulation, augments cardiac work and wall tension and therefore oxygen demand. Increased oxygen demand in the isch emic heart may result in an acutely inadequate oxygen supply and acute myocardial injury [8], An increased pre…”

Section: Discussionmentioning

confidence: 99%

The Influence of Patient Positioning on the Hemodynamic Changes in TURP Patients with Severe Coronary Disease

Kedar¹,

Gaitini²,

Vaida³

et al. 1995

Eur Urol

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“…Radioisotope dilution studies performed before and after TURP in an unselected group of 30 patients showed a fall in cardiac output of 17% (Mebust et al, 1970). A study Of 9 patients with intercurrent cardiac disease sufficient to merit a pulmonary artery catheter identified unpredictable haemodynamic responses, particularly an elevated pulmonary artery wedge pressure in 4 cases and marked changes in systemic vascular resistance in 7 cases (De Angelis et al, 1982). While pulmonary artery catheterisation is inappropriate in a study of healthy patients undergoing routine TURP, oesophageal Doppler ultrasound is an equally accurate non-invasive method of following haemodynamic trends and responses.…”

mentioning

confidence: 99%

Haemodynamic Evidence for Per‐operative Cardiac Stress during Transurethral Prostatectomy

Evans¹,

Singer²,

Chapple³

et al. 1991

British Journal of Urology

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Haemodynamic changes were measured during routine transurethral prostatectomy (TURP). The heart rate and stroke volume fell progressively over the first 30 min of surgery, resulting in a steady reduction in cardiac output. There was a significant increase in left ventricular afterload from commencement of the procedure. These findings demonstrate that haemodynamic responses, which are not detectable using conventional methods of monitoring, occur during TURP. Increased left ventricular afterload indicates increased myocardial work and oxygen demand which could result in myocardial ischaemia. This may contribute to the increased cardiovascular morbidity and mortality which have been reported to occur after TURP. The possible underlying mechanisms are discussed.

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Hemodynamic Changes During Prostatectomy in Cardiac Patients

Cited by 3 publications

References 0 publications

Haemodynamics and fluid balance after intravenous infusion of 1.5% glycine in sheep

Haemodynamics and fluid balance after intravenous infusion of 1.5% glycine in sheep

The Influence of Patient Positioning on the Hemodynamic Changes in TURP Patients with Severe Coronary Disease

Haemodynamic Evidence for Per‐operative Cardiac Stress during Transurethral Prostatectomy

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