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Articles in PresS, published online ahead of print June 20, 2002
Am J Physiol Heart Circ Physiol, 10.1152/ajpheart.00308.2002
Submitted on April 8, 2002
Accepted on June 14, 2002
1 Faculte de Medecine, Laboratoire de Pharmacologie et de Physiologie Cardiovasculaire, Amiens, France, Metropolitan
2 CHU Bicetre, Service de Reanimation Medicale, Le Kremlim-Bicetre, France, Metropolitan
3 Research Division, Ochsner Clinic Foundation, New Orleans, LA, USA
* To whom correspondence should be addressed. E-mail: MSlama0508{at}aol.com.
In 12 mechanically ventilated and anesthesied rabbits we investigated whether the magnitude of respiratory changes in aortic velocity time integral, 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, aortic diameter and velocity time integral (VTIao) were recorded in order to calculate stroke volume (SV), cardiac output (CO). Respiratory changes of VTIao (maximal-minimal 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, appeared 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
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