A comprehensive echocardiographic analysis during simulated hypovolaemia: An observational study.
Eur J Anaesthesiol
; 40(8): 578-586, 2023 08 01.
Article
em En
| MEDLINE
| ID: mdl-37265333
ABSTRACT
BACKGROUND:
Peri-operative and critically ill patients often experience mild to moderate hypovolaemic shock with preserved mean arterial pressure (MAP), heart rate (HR) and decreased stroke volume index (SVI).OBJECTIVES:
The aim of this study was to evaluate echocardiographic parameters during simulated mild to moderate central hypovolaemia.DESIGN:
This was a prospective preclinical study.SETTING:
Laboratory trial performed in Charité-Universitätsmedizin Berlin, Germany. PATIENTS ANDMETHODS:
Thirty healthy male volunteers underwent graded central hypovolaemia using a lower body negative pressure (LBNP) chamber with a stepwise decrease to simulate a mild (-15 mmHg), mild-to-moderate (-30 mmHg), and moderate state of hypovolaemic shock (-45 mmHg). During every stage, a transthoracic echocardiography examination (TTE) was performed by a certified examiner. MAIN OUTCOMEMEASURES:
Systolic and diastolic myocardial performance markers, as well as cardiac volumes were recorded during simulated hypovolaemia and compared to baseline values.RESULTS:
During simulated hypovolaemia via LBNP, SVI decreased progressively at all stages, whereas MAP and HR did not consistently change. Left ventricular (LV) ejection fraction decreased at -30 and -45 mmHg. Simultaneously with SVI decline, LV global longitudinal strain (LV GLS), tricuspid annular plain systolic excursion (TAPSE), and right ventricular RV S' and left-atrial end-systolic volume (LA ESV) decreased compared to baseline at all stages.CONCLUSIONS:
In this study, simulated central hypovolaemia using LBNP did not induce consistent changes in MAP and HR. SVI decreased and was associated with deteriorated right- and left-ventricular function, observed with echocardiography. The decreased filling status was characterised by decreased LA ESV. CLINICAL TRIAL NUMBER ClinicalTrials.gov Identifier NCT03481855.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Assunto principal:
Ecocardiografia
/
Hipovolemia
Tipo de estudo:
Observational_studies
/
Risk_factors_studies
Limite:
Humans
/
Male
Idioma:
En
Revista:
Eur J Anaesthesiol
Assunto da revista:
ANESTESIOLOGIA
Ano de publicação:
2023
Tipo de documento:
Article