Document Detail


Cardiovascular changes during drainage of pericardial effusion by thoracoscopy.
MedLine Citation:
PMID:  14665559     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Cardiovascular changes during drainage of pericardial effusion are not well understood, and most studies are of systemic effects and not of right ventricular performance. Thoracoscopy is not widely used to drain pericardial effusions because of haemodynamic changes in relation to the use of single lung ventilation. PATIENTS AND METHODS: We studied 16 patients undergoing partial pericardiectomy for pericardial effusion, using videothoracoscopy with a low-pressure pneumothorax (6 mm Hg). Cardiac output was measured by thermodilution with the patient anaesthetized in the supine position before the procedure; in the right lateral position after a low-pressure pneumothorax had been established; and after drainage of the pericardial effusion. RESULTS: Before the procedure, cardiac output was low and central venous pressure and pulmonary artery occlusion pressure were increased. Systemic vascular resistance and arterial blood pressure were within normal limits. Cardiac filling pressure and pulmonary arterial pressure increased during the pneumothorax. After the drainage cardiac index increased and systemic and pulmonary vascular resistances were reduced. CONCLUSIONS: Pericardial effusion reduces right ventricular distensibility, right and left systolic ventricular function, and cardiac output. Anaesthesia with mechanical ventilation and a low-pressure pneumothorax do not affect the circulation greatly. Drainage of the pericardial effusion allows cardiac distensibility to increase and cardiac performance changes to allow increased ejection.
Authors:
J A Fernández; R Robles; F Acosta; T Sansano; P Parrilla
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  British journal of anaesthesia     Volume:  92     ISSN:  0007-0912     ISO Abbreviation:  Br J Anaesth     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2003-12-10     Completed Date:  2004-01-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  89-92     Citation Subset:  IM    
Affiliation:
Servicio de Cirugía I and Servicio de Anestesiología y Reanimación, Hospital Universitario Virgen de la Arrixaca, El Palmar S/N, Murcia E-30120, Spain. jumanjico@yahoo.com
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Cardiac Output
Drainage / methods
Female
Hemodynamics / drug effects*
Humans
Male
Middle Aged
Pericardial Effusion / physiopathology,  surgery*
Pericardiectomy / methods*
Pneumothorax, Artificial / methods
Thoracic Surgery, Video-Assisted*
Vascular Resistance

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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