Changes in cardiac pumping efficiency and intra-thoracic organ volume during negative pressure wound therapy of sternotomy wounds, assessment using magnetic resonance imaging.

International Wound Journal
Christian TorbrandMalin Malmsjö

Abstract

Knowledge on the effects of negative pressure wound therapy (NPWT) on the intra-thoracic organs is limited. The present study was performed to investigate the effects of NPWT on the volume of the intra-thoracic organs, using magnetic resonance imaging (MRI), in a porcine sternotomy wound model. Six pigs underwent median sternotomy followed by NPWT at -75, -125 and -175 mmHg. Six pigs were not sternotomised. MR images covering the thorax and heart were acquired. The volumes of the thoracic cavity, lungs, wound fluid and heart were then determined. The volumes of the thoracic cavity and intra-thoracic organs increased after sternotomy and decreased upon NPWT application. The total heart volume variation, which is inversely related to cardiac pumping efficiency, was higher after sternotomy and decreased during NPWT. NPWT did not result in the evacuation of wound fluid from the bottom of the wound. NPWT largely closes and restores the thoracic cavity. Cardiac pumping efficiency returns to pre-sternotomy levels during NPWT. This may contribute to the clinical benefits of NPWT over open-chest care, including the stabilizing effects and the reduced need for mechanical ventilation.

References

Dec 7, 2002·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·I R RamnarineJ C S Pollock
Dec 31, 2003·The Journal of Surgical Research·Anne M ConquestW Randolph Chitwood
Mar 16, 2004·American Journal of Physiology. Heart and Circulatory Physiology·Marcus CarlssonHakan Arheden
May 28, 2005·The Annals of Thoracic Surgery·Johan SjögrenRichard Ingemansson
Jun 27, 2006·Plastic and Reconstructive Surgery·Michael J MorykwasJoseph Argenta
May 1, 2007·The Journal of Thoracic and Cardiovascular Surgery·Rainer PetzinaMalin Malmsjö
Sep 28, 2007·Plastic and Reconstructive Surgery·Malin MalmsjöJohan Sjögren

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Citations

Oct 6, 2010·Journal of Cardiothoracic Surgery·Christian TorbrandMalin Malmsjö
Sep 23, 2016·Journal of the American Veterinary Medical Association·Mirja C NolffAndrea Meyer-Lindenberg

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