Document Detail

Continuous right ventricular end-diastolic volume in comparison with left ventricular end-diastolic area.
MedLine Citation:
PMID:  19276913     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: Intraoperative management of patients with end-stage liver disease undergoing liver transplantation requires fluid administration to increase cardiac output and oxygen delivery to the tissues. Filling pressures have been widely shown to correlate poorly with changes in cardiac output in the critically ill patient. Continuous right ventricular end-diastolic volume index (cRVEDVI) and left ventricular end-diastolic area index (LVEDAI) monitoring have been increasingly used for preload assessment. The aim of this study was to compare cRVEDVI, LVEDAI, central venous pressure and pulmonary artery occlusion pressure with respect to stroke volume index (SVI) during liver transplantation. METHODS: Measurements were made in 20 patients at four predefined steps during liver transplantation. Univariate and multivariate panel-data fixed effect regression models (across phases of the surgical procedure) were fitted to assess associations between SVI and cRVEDVI, pulmonary artery occlusion pressure, central venous pressure and LVEDAI after adjusting for ejection fraction (categorized as <or=30, 31-40, >40). RESULTS: SVI was associated with continuous right ventricular ejection fraction. The model showing the best fit to the data was that including cRVEDVI: even after adjusting for continuous right ventricular ejection fraction and phase, the regression coefficient of cRVEDVI in predicting SVI was statistically significant and indicated an increase in SVI of 0.21 ml m(-2) for each increase of 1 ml m(-2). At the multivariate analysis, an increase in LVEDAI of 1 cm m(-2) led to an increase in SVI of 1.47 ml m(-2) (P = 0.054). CONCLUSION: cRVEDVI and LVEDAI gave a better reflection of preload than filling pressure, even if only cRVEDVI reached statistical significance.
Giorgio Della Rocca; Maria Gabriella Costa; Cecilia Coccia; Livia Pompei; Valeria Salandin; Di Marco Pierangelo; Paolo Pietropaoli
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Publication Detail:
Type:  Comparative Study; Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  26     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2009 Apr 
Date Detail:
Created Date:  2009-03-11     Completed Date:  2009-08-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  272-8     Citation Subset:  IM    
Department of Anaesthesia and Intensive Care Medicine, University of Udine, Udine, Italy.
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MeSH Terms
Anesthesia, General
Central Venous Pressure / physiology
Echocardiography, Transesophageal
Fluid Therapy*
Liver Diseases / surgery
Liver Transplantation / physiology*
Middle Aged
Monitoring, Physiologic / methods*
Pulmonary Wedge Pressure / physiology*
Stroke Volume / physiology
Ventricular Function, Left / physiology*
Ventricular Function, Right / physiology*
Comment In:
Eur J Anaesthesiol. 2009 Apr;26(4):269-71   [PMID:  19276912 ]

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