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Title

Continuous haemodynamic monitoring using transoesophageal Doppler during acute normovolaemic haemodilution in patients with coronary artery disease

Authors
Diaper, J
Published in Anaesthesia. 2004, vol. 59, no. 2, p. 108-15
Abstract Transoesophageal Doppler monitoring allows non-invasive assessment of stroke volume. We studied haemodynamic changes during acute normovolemic haemodilution (ANH) in anaesthetised patients with coronary artery disease. Twenty patients were randomly assigned to either ANH or a control group. During ANH, a mean (SD) blood volume of 15.3 (3.4) ml.kg(-1) was withdrawn decreasing systemic oxygen delivery from 12.7 (3.3) to 9.3 (1.8) ml.kg(-1).min(-1) (p < 0.001). In the control group, haemodynamic data remained unchanged, whereas in the ANH group, stroke volume and central venous pressure increased significantly (mean = +21 ml [95% CI: 18-25 ml.min(-1)]; mean = +2.5 mmHg [95% CI: 2.2-2.8 mmHg], respectively) and heart rate decreased (mean = -6 beat.min(-1)[95% CI: 6-8 beat.min(-1)], p < 0.05). According to the Frank-Starling relationship, individual changes in stroke volume compared with central venous pressure fitted a quadratic regression model (R2 > 0.91). A reduced viscosity associated with ANH resulted in improved venous return, higher cardiac preload and increased cardiac output. In summary, this study demonstrated that ANH to a haemoglobin value of 8.6 g.dl(-1) was well tolerated in patients with coronary artery disease.
Keywords AdultAgedAged, 80 and overCardiac OutputCoronary Artery BypassCoronary Artery Disease/surgery/therapy/ultrasonographyEchocardiography, TransesophagealFemaleHemodilutionHemodynamicsHemoglobins/metabolismHumansIntraoperative Care/methodsMaleMiddle AgedMonitoring, Intraoperative/methods
Identifiers
PMID: 14725511
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Structures
Research groups Dysfonctions cardio-pulmonaires et cérébrales (278)
Chirurgie cardio-vasculaire (105)
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LICKER, Marc et al. Continuous haemodynamic monitoring using transoesophageal Doppler during acute normovolaemic haemodilution in patients with coronary artery disease. In: Anaesthesia, 2004, vol. 59, n° 2, p. 108-15. https://archive-ouverte.unige.ch/unige:41778

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Deposited on : 2014-11-13

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