Pleural effusion decreases left ventricular pre-load and causes haemodynamic compromise: an experimental porcine study

Acta Anaesthesiologica Scandinavica
K B WemmelundE Sloth

Abstract

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. 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. 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 decr...Continue Reading

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Citations

May 25, 2013·Journal of Radiology Case Reports·Vincent LenoirXavier Montet
Dec 3, 2014·Revue de pneumologie clinique·P EsnaultE Meaudre
Dec 4, 2013·Scandinavian Cardiovascular Journal : SCJ·Lærke Kamstrup ChristiansenErik Sloth
Dec 15, 2015·Current Opinion in Anaesthesiology·Martin Ruben Skou JørgensenErik Sloth
Jul 1, 2015·Intensive Care Medicine·Raphaël GiraudKarim Bendjelid
May 29, 2013·Journal of Clinical Ultrasound : JCU·Rami N Khouzam, Jawwad Yusuf
Mar 25, 2014·Journal of Cardiothoracic and Vascular Anesthesia·Johan F HermansenErik Sloth
Jul 13, 2016·European Journal of Cardio-thoracic Surgery : Official Journal of the European Association for Cardio-thoracic Surgery·Laura Sommer HansenErik Sloth
Jan 13, 2017·European Journal of Anaesthesiology·Kristian B WemmelundPeter Juhl-Olsen
Apr 17, 2018·European Journal of Anaesthesiology·Kristian B WemmelundErik Sloth
Oct 20, 2018·Echocardiography·Henrik Lynge HovgaardPeter Juhl-Olsen
Sep 13, 2017·Intensive Care Medicine Experimental·Kristian Borup WemmelundPeter Juhl-Olsen

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