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[Hemodynamic monitoring using esophageal Doppler ultrasonography during laparoscopic cholecystectomy]. / Monitorage hémodynamique par Doppler oesophagien lors de la cholécystectomie par coelioscopie.
Mann, C; Boccara, G; Pouzeratte, Y; Navarro, F; Domergue, J; Colson, P.
Afiliação
  • Mann C; Département d'Anesthésie Réanimation B, Hôpital St Eloi, CHU, Montpellier, France.
Can J Anaesth ; 46(1): 15-20, 1999 Jan.
Article em Fr | MEDLINE | ID: mdl-10078397
PURPOSE: To evaluate the use of a 4-mHz continuous wave esophageal Doppler monitor in the hemodynamic management of 48 ASA I to III patients undergoing laparoscopic cholecystectomy. METHODS: General anesthesia was induced with fentanyl and propofol, maintained with N20 N20/02 and muscle relaxation was provided with atracurium. The lungs were mechanically ventilated. Non invasive arterial blood pressure, heart rate, capnography, arterial blood gas were monitored during CO2 pneumoperitoneum at 15-mmHg. Using the velocity waveform of descending aortic blood flow, the Doppler device estimated changes in cardiac output and systemic vascular resistances. RESULTS: Peritoneal insufflation resulted in a mean 19% decrease in cardiac output (range -49 to +5%; P < 0.05) and a mean 48% increased in systemic vascular resistances (range -7 to +101%; P < 0.01). There was no relationship between changes in cardiac output and mean arterial pressure or PETCO2. The esophageal Doppler provided, in two patients, details of hypertensive peaks (mean arterial pressure > 140 mmHg) which responded to administration of nicardipine. CONCLUSION: The Esophageal Doppler provided an easy-to-handle and non invasive tool to monitor changes in cardiac output during laparoscopic cholecystectomy. However, further comparison with a thermodilution cardiac output technique is required.
Assuntos
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Colecistectomia Laparoscópica / Ecocardiografia Transesofagiana / Hemodinâmica Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: Fr Revista: Can J Anaesth Assunto da revista: ANESTESIOLOGIA Ano de publicação: 1999 Tipo de documento: Article País de afiliação: França
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Coleções: 01-internacional Base de dados: MEDLINE Assunto principal: Colecistectomia Laparoscópica / Ecocardiografia Transesofagiana / Hemodinâmica Limite: Adult / Aged / Aged80 / Female / Humans / Male / Middle aged Idioma: Fr Revista: Can J Anaesth Assunto da revista: ANESTESIOLOGIA Ano de publicação: 1999 Tipo de documento: Article País de afiliação: França