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Article: Transoesophageal acoustic quantification for evaluation of cardiac function during laparoscopic surgery

TitleTransoesophageal acoustic quantification for evaluation of cardiac function during laparoscopic surgery
Authors
Issue Date2001
PublisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0003-2409
Citation
Anaesthesia (Oxford), 2001, v. 56 n. 7, p. 623-629 How to Cite?
AbstractPneumoperitoneum may be poorly tolerated in patients with marginal cardiopulmonary function. Transoesophageal echocardiography is a relatively non-invasive technique that can track changes in left ventricular cavity area using acoustic quantification and has been found to provide a reliable, real-time estimation of left ventricular function. We evaluated mid-papillary fractional area change during pneumoperitoneum in 17 healthy adult patients (group 1) and 17 with hypertension and/or ischaemic heart disease (group 2) undergoing laparoscopic cholecystectomy. Peritoneal insufflation led to significant (p < 0.01) decreases in fractional area change and an increase in mean blood pressure. There was no significant change in heart rate. Patients with cardiovascular disease who had a > 30% decrease in fractional area change following carbon dioxide insufflation (group 2B) were given an intravenous infusion of glyceryl trinitrate. In groups 1 and 2A, fractional area change improved slightly with head-up tilt and continued to improve over the course of surgery. Glyceryl trinitrate led to a significant increase in fractional area change and a decrease in mean blood pressure back to baseline values. We conclude that peritoneal insufflation of carbon dioxide results in a significant increase in cardiac workload that is well tolerated in patients with no cardiovascular disease. Coexisting cardiovascular disease can result in even more pronounced impairment of cardiac function, which may not be predictable by clinical assessment or adequately determined by routine monitoring. We recommend the use of transoesophageal acoustic quantification as a monitor in these patients and the administration of glyceryl trinitrate to ameliorate myocardial stress.
Persistent Identifierhttp://hdl.handle.net/10722/67319
ISSN
2015 Impact Factor: 3.794
2015 SCImago Journal Rankings: 1.404
ISI Accession Number ID
References

 

DC FieldValueLanguage
dc.contributor.authorIrwin, MGen_HK
dc.contributor.authorNg, JKFen_HK
dc.date.accessioned2010-09-06T05:53:56Z-
dc.date.available2010-09-06T05:53:56Z-
dc.date.issued2001en_HK
dc.identifier.citationAnaesthesia (Oxford), 2001, v. 56 n. 7, p. 623-629en_HK
dc.identifier.issn0003-2409en_HK
dc.identifier.urihttp://hdl.handle.net/10722/67319-
dc.description.abstractPneumoperitoneum may be poorly tolerated in patients with marginal cardiopulmonary function. Transoesophageal echocardiography is a relatively non-invasive technique that can track changes in left ventricular cavity area using acoustic quantification and has been found to provide a reliable, real-time estimation of left ventricular function. We evaluated mid-papillary fractional area change during pneumoperitoneum in 17 healthy adult patients (group 1) and 17 with hypertension and/or ischaemic heart disease (group 2) undergoing laparoscopic cholecystectomy. Peritoneal insufflation led to significant (p < 0.01) decreases in fractional area change and an increase in mean blood pressure. There was no significant change in heart rate. Patients with cardiovascular disease who had a > 30% decrease in fractional area change following carbon dioxide insufflation (group 2B) were given an intravenous infusion of glyceryl trinitrate. In groups 1 and 2A, fractional area change improved slightly with head-up tilt and continued to improve over the course of surgery. Glyceryl trinitrate led to a significant increase in fractional area change and a decrease in mean blood pressure back to baseline values. We conclude that peritoneal insufflation of carbon dioxide results in a significant increase in cardiac workload that is well tolerated in patients with no cardiovascular disease. Coexisting cardiovascular disease can result in even more pronounced impairment of cardiac function, which may not be predictable by clinical assessment or adequately determined by routine monitoring. We recommend the use of transoesophageal acoustic quantification as a monitor in these patients and the administration of glyceryl trinitrate to ameliorate myocardial stress.en_HK
dc.languageengen_HK
dc.publisherWiley-Blackwell Publishing Ltd.. The Journal's web site is located at http://www.wiley.com/bw/journal.asp?ref=0003-2409en_HK
dc.relation.ispartofAnaesthesia (Oxford)en_HK
dc.rightsThe definitive version is available at www3.interscience.wiley.comen_HK
dc.subject.meshCardiovascular Diseases - drug therapy - physiopathology - ultrasonographyen_HK
dc.subject.meshCholecystectomy, Laparoscopicen_HK
dc.subject.meshEchocardiography, Transesophagealen_HK
dc.subject.meshMonitoring, Intraoperative - methodsen_HK
dc.subject.meshVentricular Function, Leften_HK
dc.titleTransoesophageal acoustic quantification for evaluation of cardiac function during laparoscopic surgeryen_HK
dc.typeArticleen_HK
dc.identifier.openurlhttp://library.hku.hk:4550/resserv?sid=HKU:IR&issn=0003-2409&volume=56&spage=623&epage=629&date=2001&atitle=Transoesophageal+acoustic+quantification+for+evaluation+of+cardiac+function+during+laparoscopic+surgeryen_HK
dc.identifier.emailIrwin, MG: mgirwin@hkucc.hku.hken_HK
dc.identifier.emailNg, JKF: jkfng@hku.hken_HK
dc.identifier.authorityIrwin, MG=rp00390en_HK
dc.identifier.authorityNg, JKF=rp00544en_HK
dc.description.naturelink_to_subscribed_fulltext-
dc.identifier.doi10.1046/j.1365-2044.2001.01981.xen_HK
dc.identifier.pmid11437761-
dc.identifier.scopuseid_2-s2.0-0034933414en_HK
dc.identifier.hkuros67164en_HK
dc.relation.referenceshttp://www.scopus.com/mlt/select.url?eid=2-s2.0-0034933414&selection=ref&src=s&origin=recordpageen_HK
dc.identifier.volume56en_HK
dc.identifier.issue7en_HK
dc.identifier.spage623en_HK
dc.identifier.epage629en_HK
dc.identifier.isiWOS:000169889700004-
dc.publisher.placeUnited Kingdomen_HK

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