| Pleural effusion decreases left ventricular pre-load and causes haemodynamic compromise: an experimental porcine study. | |
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MedLine Citation:
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PMID: 22571346 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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BACKGROUND: Although pleural effusion is a common complication in critically ill patients, detailed knowledge is missing about the haemodynamic impact and the underlining mechanisms. The aim of this study was to evaluate the haemodynamic effect of incremental pleural effusion by means of invasive haemodynamic parameters and transthoracic echocardiography. METHODS: This experimental interventional study was conducted using 22 female piglets (17.5-21.5 kg) randomized for right-side (n = 9) and left-side (n = 9) pleural effusion, or sham operation (n = 4). Pleural effusion was induced by infusing incremental volumes of saline into the pleural cavity. Invasive haemodynamic measurements and echocardiographical images were obtained at baseline, a volume of 45 ml/kg, a volume of 75 ml/kg and 45 min after drainage. RESULTS: No difference (all P > 0.147) was found between right- and left-side pleural effusion, and the groups were thus pooled. At 45 ml/kg cardiac output, mean arterial pressure, stroke volume and mixed venous saturation decreased (all P < 0.003); central venous pressure and pulmonary arterial pressure increased (both P > 0.003) at this point. The changes accelerated at 75 ml/kg. At 45 ml/kg left ventricular pre-load in terms of end-diastolic area decreased significantly (P < 0.001). The effect on haemodynamics and cardiac dimensions changed dramatically at 75 ml/kg. Cardiac output, mean arterial pressure, central venous pressure and left ventricular end-diastolic area returned to normal during a recovery period of 45 min (all P > 0.061). CONCLUSION: Incremental volumes of unilateral pleural effusion induced a significant haemodynamic impact fully reversible after drainage. Pleural effusion causes a significant decrease of left ventricular pre-load in a diverse picture of haemodynamic compromise. |
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Authors:
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K B Wemmelund; R H Lie; P Juhl-Olsen; C A Frederiksen; J F Hermansen; E Sloth |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2012-5-9 |
Journal Detail:
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Title: Acta anaesthesiologica Scandinavica Volume: - ISSN: 1399-6576 ISO Abbreviation: - Publication Date: 2012 May |
Date Detail:
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Created Date: 2012-5-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 0370270 Medline TA: Acta Anaesthesiol Scand Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Copyright Information:
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© 2012 The Authors. Acta Anaesthesiologica Scandinavica © 2012 The Acta Anaesthesiologica Scandinavica Foundation. |
Affiliation:
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Department of Anaesthesiology and Intensive Care, Aarhus University Hospital, Aarhus, Denmark. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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