title: Determination of right ventricular volumes during aortic surgery.
abstract: The aim of the present study was to evaluate right ventricular (RV) preload by measurements of right ventricular volumes during aortic clamping and unclamping. Nine patients (aged 67 +/- 9 years) undergoing infrarenal aortic aneurysmectomy were monitored with a pulmonary artery catheter equipped with a fast-response thermistor, allowing determination of RV volumes by the thermodilution technique. Anesthesia consisted of a continuous infusion of alfentanil and 50% N2O. Aortic clamping resulted in a significant decrease in cardiac index (CI) and a significant increase in systemic vascular resistance (SVR). There was no significant change in right ventricular ejection fraction (RVEF) (from 35% +/- 6% to 33% +/- 8%) in the presence of a significant decrease in stroke index (from 37.2 +/- 9.8 to 31.1 +/- 10.0 mL/beat/m2, P less than 0.05), indicating a significant decrease in RV end-diastolic volume (from 106 +/- 17 to 92 +/- 19 mL, P less than 0.01). There were no significant changes in cardiac filling pressures. Aortic unclamping was associated with a significant increase in CI and a significant decrease in SVR. There were no significant changes in cardiac filling pressures, RVEF, or RV volumes. Measurements of RV volumes indicated that aortic clamping resulted in a decrease in RV preload, which is usually not demonstrated by measurements of right atrial pressure alone.
authors.affiliation: Department of Anesthesiology, Erasme University Hospital, Brussels, Belgium.
authors.forename: P
authors.initials: P
authors.lastname: Van der Linden
authors.forename: E
authors.initials: E
authors.lastname: Gilbart
authors.forename: E
authors.initials: E
authors.lastname: Engelman
authors.forename: M
authors.initials: M
authors.lastname: de Rood
authors.forename: J L
authors.initials: JL
authors.lastname: Vincent
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D001011:Aorta / Q000601:surgery*; D001014:Aortic Aneurysm / Q000601:surgery; D001794:Blood Pressure / Q000502:physiology; D002302:Cardiac Output / Q000502:physiology; D002306:Cardiac Volume / Q000502:physiology*; D003250:Constriction; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D010101:Oxygen Consumption / Q000502:physiology; D011651:Pulmonary Artery; D013318:Stroke Volume / Q000502:physiology; D014655:Vascular Resistance / Q000502:physiology; D016278:Ventricular Function, Right / Q000502:physiology*