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Thoracic aortic pulsatility decreases during hypovolemic shock: implications for stent-graft sizing.
MedLine Citation:
PMID:  21861735     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
Abstract Purpose: To investigate the thoracic aortic pulsatility during hypovolemic shock in an experimental porcine model. Methods: The circulating blood volume of 7 healthy Yorkshire pigs was gradually lowered until the subjects had lost 40% of their normal blood volume. Intravascular ultrasound was used to assess the aortic pulsatility in normovolemic and hypovolemic state at the level of the ascending and descending thoracic aorta. Results: The mean aortic pulsatility at the level of the ascending aorta decreased from 15.9%±7.2% (range 6.3%-25.7%) in normovolemia to 6.2%±2.8% (range 2.9%-10.7%, p = 0.018) in hypovolemia. At the level of the descending thoracic aorta, the mean aortic pulsatility decreased from 8.7%±2.8% (range 4.4%-12.2%) at baseline to 5.6%±2.5% (range 1.5%-9.5%, p = 0.028) in hypovolemia. The maximum mean aortic diameter, obtained in cardiac systole, was significantly smaller as well at both evaluated levels during hypovolemic shock compared with the mean diameter in normovolemia. Conclusion: The thoracic aortic diameter and pulsatility decreased significantly during hypovolemic shock in this porcine model, most impressively at the level of the ascending aorta. Electrocardiographically-gated imaging may not be necessary for hypovolemic patients with acute aortic disease requiring endovascular repair because of the minimal aortic pulsatility.
Authors:
Frederik H W Jonker; Jasper W van Keulen; Felix J V Schlosser; Jeffrey E Indes; Frans L Moll; Hence J M Verhagen; Bart E Muhs
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of endovascular therapy : an official journal of the International Society of Endovascular Specialists     Volume:  18     ISSN:  1545-1550     ISO Abbreviation:  J. Endovasc. Ther.     Publication Date:  2011 Aug 
Date Detail:
Created Date:  2011-08-24     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100896915     Medline TA:  J Endovasc Ther     Country:  United States    
Other Details:
Languages:  eng     Pagination:  491-6     Citation Subset:  IM    
Affiliation:
1 Section of Vascular Surgery, Maasstad Hospital, Rotterdam, The Netherlands.
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