[Noninvasive monitoring with echocardiography. I. Ventricular function following thiopental and positive pressure breathing].
Using continuous M-mode echocardiography for measuring diameters of the left ventricle and calculating variables of left ventricular contractility during induction of anaesthesia the hemodynamic effects of thiopentone and of positive end-expiratory pressure breathing (PEEP) have been noninvasively assessed in 22 patients undergoing minor surgery (series A, n = 4 + 6, thiopentone) or cholecystectomy (series B, n = 12, PEEP). 4 mg X kg-1 i.v. (group I, n = 4) and 2 X 4 mg X kg-1, the second dose injected i.v. 5 min later (group II, n = 6), led in group I to a short lasting and in group II to a prolonged (duration of each experiment 10 min) significant decrease of the ejection fraction (EF), the shortening fraction (FS) and the mean velocity of circumferential fiber shortening (VCF mean). Thus the well known negative inotropic effect of thiopentone has been proven once more this time by noninvasive echocardiography. The influence of PEEP 5 and 10 cm H2O was evaluated in two ways: 1) by finding the incidence and extent of diminishing the "echocardiographic window" due to overexpansion of the lung during PEEP, rendering the sonographic visualization of the cardiac structures less valid, and 2) by assessing potential haemodynamic effects of PEEP. The curves of 3 in 12 cases (25%) have not been able to be evaluated properly because of "window closing"; in the residual 9 patients during PEEP 10 a significant decrease of the above mentioned parameters of contractility in comparison to PEEP 0 has been observed. IPPB without PEEP apparently does not disturb echocardiographic visualization.(ABSTRACT TRUNCATED AT 250 WORDS)
D000293:Adolescent; D000328:Adult; D000758:Anesthesia; D002496:Central Venous Pressure / Q000187:drug effects; D004452:Echocardiography; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D011175:Positive-Pressure Respiration; D013874:Thiopental; D016276:Ventricular Function
D013874:Thiopental
Nichtinvasives Monitoring mittels Echocardiographie. I. Ventrikelfunktion nach Thiopental und Beatmung.