title: The effect of propofol on haemodynamics: cardiac output, venous return, mean systemic filling pressure, and vascular resistances.
abstract: BACKGROUND
  Although arterial hypotension occurs frequently with propofol use in humans, its effects on intravascular volume and vascular capacitance are uncertain. We hypothesized that propofol decreases vascular capacitance and therefore decreases stressed volume.
  
  
  METHODS
  Cardiac output (CO) was measured using Modelflow(®) in 17 adult subjects after upper abdominal surgery. Mean systemic filling pressure (MSFP) and vascular resistances were calculated using venous return curves constructed by measuring steady-state arterial and venous pressures and CO during inspiratory hold manoeuvres at increasing plateau pressures. Measurements were performed at three incremental levels of targeted blood propofol concentrations.
  
  
  RESULTS
  Mean blood propofol concentrations for the three targeted levels were 3.0, 4.5, and 6.5 µg ml(-1). Mean arterial pressure, central venous pressure, MSFP, venous return pressure, Rv, systemic arterial resistance, and resistance of the systemic circulation decreased, stroke volume variation increased, and CO was not significantly different as propofol concentration increased.
  
  
  CONCLUSIONS
  An increase in propofol concentration within the therapeutic range causes a decrease in vascular stressed volume without a change in CO. The absence of an effect of propofol on CO can be explained by the balance between the decrease in effective, or stressed, volume (as determined by MSFP), the decrease in resistance for venous return, and slightly improved heart function.
  
  
  BACKGROUND
  Netherlands Trial Register: NTR2486.
authors.affiliation: Department of Anaesthesiology, Leiden University Medical Centre, Leiden, The Netherlands fdewit@lumc.nl.
authors.forename: F
authors.initials: F
authors.lastname: de Wit
authors.affiliation: Department of Anaesthesiology, Alrijne Hospital, Leiderdorp, The Netherlands.
authors.forename: A L
authors.initials: AL
authors.lastname: van Vliet
authors.affiliation: Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: R B
authors.initials: RB
authors.lastname: de Wilde
authors.affiliation: Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: J R
authors.initials: JR
authors.lastname: Jansen
authors.affiliation: Department of Anaesthesiology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: J
authors.initials: J
authors.lastname: Vuyk
authors.affiliation: Department of Anaesthesiology, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: L P
authors.initials: LP
authors.lastname: Aarts
authors.affiliation: Department of Intensive Care, Leiden University Medical Centre, Leiden, The Netherlands.
authors.forename: E
authors.initials: E
authors.lastname: de Jonge
authors.affiliation: Department of Anaesthesiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: D P
authors.initials: DP
authors.lastname: Veelo
authors.affiliation: Department of Anaesthesiology, Leiden University Medical Centre, Leiden, The Netherlands Department of Anaesthesiology, Academic Medical Centre, Amsterdam, The Netherlands.
authors.forename: B F
authors.initials: BF
authors.lastname: Geerts
mesh_terms: D000005:Abdomen / Q000601:surgery; D000328:Adult; D000368:Aged; D000465:Algorithms; D018686:Anesthetics, Intravenous; D001810:Blood Volume / Q000187:drug effects; D002302:Cardiac Output / Q000187:drug effects*; D005260:Female; D006334:Heart Function Tests; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D008297:Male; D008875:Middle Aged; D015742:Propofol; D013318:Stroke Volume; D018924:Vascular Capacitance / Q000187:drug effects; D014655:Vascular Resistance / Q000187:drug effects*; D014690:Venous Pressure / Q000187:drug effects
chemical_list: D018686:Anesthetics, Intravenous; D015742:Propofol
keywords: anaesthetics, intravenous; cardiac output; propofol; vascular capacitance