Research ExplorerPublicationsEffects of mid-line thoracotomy on the interaction between m...

Effects of mid-line thoracotomy on the interaction between mechanical ventilation and cardiac filling during cardiac surgery

Standard

Effects of mid-line thoracotomy on the interaction between mechanical ventilation and cardiac filling during cardiac surgery. / Reuter, D A; Goresch, T; Goepfert, M S G; Wildhirt, S M; Kilger, E; Goetz, A E.

In: BRIT J ANAESTH, Vol. 92, No. 6, 01.06.2004, p. 808-13.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Reuter, DA, Goresch, T, Goepfert, MSG, Wildhirt, SM, Kilger, E & Goetz, AE 2004, 'Effects of mid-line thoracotomy on the interaction between mechanical ventilation and cardiac filling during cardiac surgery', BRIT J ANAESTH, vol. 92, no. 6, pp. 808-13. https://doi.org/10.1093/bja/aeh151

APA

Reuter, D. A., Goresch, T., Goepfert, M. S. G., Wildhirt, S. M., Kilger, E., & Goetz, A. E. (2004). Effects of mid-line thoracotomy on the interaction between mechanical ventilation and cardiac filling during cardiac surgery. BRIT J ANAESTH, 92(6), 808-13. https://doi.org/10.1093/bja/aeh151

Vancouver

Reuter DA, Goresch T, Goepfert MSG, Wildhirt SM, Kilger E, Goetz AE. Effects of mid-line thoracotomy on the interaction between mechanical ventilation and cardiac filling during cardiac surgery. BRIT J ANAESTH. 2004 Jun 1;92(6):808-13. https://doi.org/10.1093/bja/aeh151

Bibtex

@article{03b6a29965384493895f7cc9f7921091,
title = "Effects of mid-line thoracotomy on the interaction between mechanical ventilation and cardiac filling during cardiac surgery",
abstract = "BACKGROUND: Mid-line thoracotomy is a standard approach for cardiac surgery. However, little is known how this surgical approach affects the interaction between the circulation and mechanical ventilation. We studied how mid-line thoracotomy affects cardiac filling volumes and cardiovascular haemodynamics, particularly variations in stroke volume and pulse pressure caused by mechanical ventilation.METHODS: We studied 19 patients during elective coronary artery bypass surgery. Before and after mid-line thoracotomy, we measured arterial pressure, cardiac index (CI) and global end-diastolic volume index (GEDVI) by thermodilution, left ventricular end-diastolic area index (LVEDAI) by transoesophageal echocardiography and the variations in left ventricular stroke volume and pulse pressure during ventilation by arterial pulse contour analysis.RESULTS: After thoracotomy, CI increased from 2.3 (0.4) to 2.9 (0.6) litre min(-1) m(-2), GEDVI increased from 605 (110) to 640 (94) litre min(-1) m(-2), and LVEDAI increased from 9.2 (3.7) to 11.2 (4.1) cm(2) m(-2). All these changes were significant. In contrast, stroke volume variation (SVV) decreased from 10 (3) to 6 (2)% and pulse pressure variation (PPV) decreased from 11 (3) to 5 (3)%. Before thoracotomy, SVV and PPV significantly correlated with GEDVI (both P<0.01). When the chest was open, similar significant correlations of SVV (P<0.001) and PPV (P<0.01) were found with GEDVI.CONCLUSION: Thoracotomy increases cardiac filling and preload. Further, thoracotomy reduces the effect of mechanical ventilation on left ventricular stroke volume. However, also under open chest conditions, SVV and PPV are preload-dependent.",
keywords = "Adult, Aged, Cardiac Output, Coronary Artery Bypass, Echocardiography, Transesophageal, Female, Hemodynamics, Humans, Intraoperative Period, Male, Middle Aged, Monitoring, Intraoperative, Respiration, Artificial, Stroke Volume, Thermodilution, Thoracotomy",
author = "Reuter, {D A} and T Goresch and Goepfert, {M S G} and Wildhirt, {S M} and E Kilger and Goetz, {A E}",
year = "2004",
month = jun,
day = "1",
doi = "10.1093/bja/aeh151",
language = "English",
volume = "92",
pages = "808--13",
journal = "BRIT J ANAESTH",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "6",

}

RIS

TY - JOUR

T1 - Effects of mid-line thoracotomy on the interaction between mechanical ventilation and cardiac filling during cardiac surgery

AU - Reuter, D A

AU - Goresch, T

AU - Goepfert, M S G

AU - Wildhirt, S M

AU - Kilger, E

AU - Goetz, A E

PY - 2004/6/1

Y1 - 2004/6/1

N2 - BACKGROUND: Mid-line thoracotomy is a standard approach for cardiac surgery. However, little is known how this surgical approach affects the interaction between the circulation and mechanical ventilation. We studied how mid-line thoracotomy affects cardiac filling volumes and cardiovascular haemodynamics, particularly variations in stroke volume and pulse pressure caused by mechanical ventilation.METHODS: We studied 19 patients during elective coronary artery bypass surgery. Before and after mid-line thoracotomy, we measured arterial pressure, cardiac index (CI) and global end-diastolic volume index (GEDVI) by thermodilution, left ventricular end-diastolic area index (LVEDAI) by transoesophageal echocardiography and the variations in left ventricular stroke volume and pulse pressure during ventilation by arterial pulse contour analysis.RESULTS: After thoracotomy, CI increased from 2.3 (0.4) to 2.9 (0.6) litre min(-1) m(-2), GEDVI increased from 605 (110) to 640 (94) litre min(-1) m(-2), and LVEDAI increased from 9.2 (3.7) to 11.2 (4.1) cm(2) m(-2). All these changes were significant. In contrast, stroke volume variation (SVV) decreased from 10 (3) to 6 (2)% and pulse pressure variation (PPV) decreased from 11 (3) to 5 (3)%. Before thoracotomy, SVV and PPV significantly correlated with GEDVI (both P<0.01). When the chest was open, similar significant correlations of SVV (P<0.001) and PPV (P<0.01) were found with GEDVI.CONCLUSION: Thoracotomy increases cardiac filling and preload. Further, thoracotomy reduces the effect of mechanical ventilation on left ventricular stroke volume. However, also under open chest conditions, SVV and PPV are preload-dependent.

AB - BACKGROUND: Mid-line thoracotomy is a standard approach for cardiac surgery. However, little is known how this surgical approach affects the interaction between the circulation and mechanical ventilation. We studied how mid-line thoracotomy affects cardiac filling volumes and cardiovascular haemodynamics, particularly variations in stroke volume and pulse pressure caused by mechanical ventilation.METHODS: We studied 19 patients during elective coronary artery bypass surgery. Before and after mid-line thoracotomy, we measured arterial pressure, cardiac index (CI) and global end-diastolic volume index (GEDVI) by thermodilution, left ventricular end-diastolic area index (LVEDAI) by transoesophageal echocardiography and the variations in left ventricular stroke volume and pulse pressure during ventilation by arterial pulse contour analysis.RESULTS: After thoracotomy, CI increased from 2.3 (0.4) to 2.9 (0.6) litre min(-1) m(-2), GEDVI increased from 605 (110) to 640 (94) litre min(-1) m(-2), and LVEDAI increased from 9.2 (3.7) to 11.2 (4.1) cm(2) m(-2). All these changes were significant. In contrast, stroke volume variation (SVV) decreased from 10 (3) to 6 (2)% and pulse pressure variation (PPV) decreased from 11 (3) to 5 (3)%. Before thoracotomy, SVV and PPV significantly correlated with GEDVI (both P<0.01). When the chest was open, similar significant correlations of SVV (P<0.001) and PPV (P<0.01) were found with GEDVI.CONCLUSION: Thoracotomy increases cardiac filling and preload. Further, thoracotomy reduces the effect of mechanical ventilation on left ventricular stroke volume. However, also under open chest conditions, SVV and PPV are preload-dependent.

KW - Adult

KW - Aged

KW - Cardiac Output

KW - Coronary Artery Bypass

KW - Echocardiography, Transesophageal

KW - Female

KW - Hemodynamics

KW - Humans

KW - Intraoperative Period

KW - Male

KW - Middle Aged

KW - Monitoring, Intraoperative

KW - Respiration, Artificial

KW - Stroke Volume

KW - Thermodilution

KW - Thoracotomy

U2 - 10.1093/bja/aeh151

DO - 10.1093/bja/aeh151

M3 - SCORING: Journal article

C2 - 15096443

VL - 92

SP - 808

EP - 813

JO - BRIT J ANAESTH

JF - BRIT J ANAESTH

SN - 0007-0912

IS - 6

ER -