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1 Laboratoire de Pharmacologie et de Physiologie Cardiovasculaire, Université de Picardie Jules Vernes, Amiens 80054; 2 Service de Réanimation Médicale, Centre Hospitalier Universitaire Bicêtre, Le Kremlin-Bicêtre 94275, France; and 3 Research Division, Ochsner Clinic Foundation, New Orleans, Louisiana 70121
In 12 mechanically ventilated and
anesthetized rabbits, we investigated whether the magnitude of
respiratory changes in the aortic velocity time integral
(VTIAo), recorded by transthoracic echocardiography (TTE)
during a stepwise blood withdrawal and restitution, could be used as a
reliable indicator of volume depletion and responsiveness. At each
step, left and right ventricular dimensions and the aortic diameter and
VTIAo were recorded to calculate stroke volume (SV) and
cardiac output (CO). Respiratory changes of VTIAo (maximal 
minimal values divided by their respective means) were calculated. The amount of blood withdrawal correlated negatively with
left and right ventricular diastolic diameters, VTIAo, SV, and CO and correlated directly with respiratory changes of
VTIAo. Respiratory VTIAo variations (but not
other parameters) at the last blood withdrawal step was also correlated
with changes in SV after blood restitution (r = 0.83, P < 0.001). In conclusion, respiratory variations in
VTIAo using TTE appear to be a sensitive index of blood
volume depletion and restitution. This dynamic parameter predicted
fluid responsiveness more reliably than static markers of cardiac preload.
echocardiography; cardiopulmonary interactions; stroke volume variation; cardiac preload
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