Echocardiographic left ventricular remodeling and pseudohypertrophy as markers of hypovolemia. An experimental study on bleeding and volume repletion

Journal of the American Society of Echocardiography : Official Publication of the American Society of Echocardiography
E Di SegniZ Vered

Abstract

Monitoring intravascular volume during surgery, especially in major cardiovascular procedures is necessary for appropriate fluid restoration and the maintenance of an adequate cardiac output. In estimating preload, both standard hemodynamic and echocardiographic parameters have been limited. The purpose of this study was to further define the effects of induced hypovolemia on the echocardiographic parameters. In particular, we sought to show whether a decrease in echocardiographic left ventricular area and volume was associated with a significant increase in left ventricular wall thickness (left ventricular pseudohypertrophy) and with changes in LV function. In addition, we sought to investigate the effects of rapid restoration of blood volume on cardiac dimensions and function. Seven anesthetized pigs underwent systemic and right heart pressures and cardiac output measurements. Two-dimensional echocardiographic parasternal long- and short-axis views were obtained during graded bleeding by rapid withdrawal of blood from an arterial cannula, with increments of 5% each up to 30% of calculated blood volume. After completion of the bleeding, the entire amount of the blood withdrawn was retransfused within 4 to 5 minutes. Both hemod...Continue Reading

Citations

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