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Estimation of cardiac preload changes by systolic pressure variation in pigs undergoing pneumoperitoneum
Author(s) -
Tournadre J. P.,
Allaouchiche B.,
Cayrel V.,
Mathon L.,
Chassard D.
Publication year - 2000
Publication title -
acta anaesthesiologica scandinavica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.738
H-Index - 107
eISSN - 1399-6576
pISSN - 0001-5172
DOI - 10.1034/j.1399-6576.2000.440303.x
Subject(s) - medicine , preload , pneumoperitoneum , blood pressure , cardiology , anesthesia , hemodynamics , surgery , laparoscopy
Background: Variations in systolic pressure arterial waveform (SPV) and its component have been shown to be a reasonable indicator of left ventricular preload. Creation of a pneumoperitoneum (PMOP) by insufflation of CO 2 increases intrathoracic pressure, leading to overestimation of preload as assessed by pressure methods. The purpose of this study was to compare SPV with other standard methods in anaesthetized pigs. Methods: We measured SPV and its DeltaDown component (ΔDown), pulmonary artery occlusion pressure (PAOP) and left ventricular short‐axis cross‐sectional area using transthoracic echocardiography (TTE) in 7 pigs, at baseline, after 12 mmHg PMOP and after an intravascular load with 10 ml/kg hydroxylethylstarch (HES). Results: PMOP increased SPV from 12.9±4.9 to 16.9±5.5 mmHg ( P <0.05) and decreased pulmonary compliance, with no change in PAOP or end‐diastolic area assesssed by TTE. Intravascular volume loading significantly decreased SPV from 16.9±5.5 to 11.2±4.9 mmHg and ΔDown from 9.9±7.1 to 5.2±4.5 ( P <0.05), and increased PAOP and end‐diastolic area. Significant correlation between changes in ΔDown and EDA was noted following HES (r=0.78, P <0.05). Conclusion: In anaesthetized pigs, the creation of a PMOP alters SPV, likely by decreasing lung compliance. Once PMOP is established, changes in cardiac preload could be estimated by SPV analysis.