PMID- 15728040
OWN - NLM
STAT- MEDLINE
DCOM- 20050318
LR  - 20210902
IS  - 0003-2999 (Print)
IS  - 0003-2999 (Linking)
VI  - 100
IP  - 3
DP  - 2005 Mar
TI  - Hemodynamic effects of portal triad clamping with and without pneumoperitoneum: 
      an echocardiographic study.
PG  - 617-622
LID - 10.1213/01.ANE.0000144592.20499.12 [doi]
AB  - The decrease of cardiac index observed during portal triad clamping (PTC) with 
      and without pneumoperitoneum has been studied only with right heart 
      catheterization. To better understand this decrease of cardiac index, we 
      investigated the balance between the adequacy of preload and the ability of the 
      heart to pump against an increased afterload, by using transesophageal 
      echocardiography. Ten patients with PTC performed during laparoscopy and 10 with 
      PTC performed during laparotomy were studied. Five minutes after PTC, the stroke 
      volume, the left ventricular (LV) fractional area change (FAC), and the LV 
      end-systolic wall stress (LVESWS) were measured as the conventional hemodynamic 
      variables. Regional wall motion abnormalities (RWMA) were also recorded. In the 
      laparotomy group, LV end-diastolic area decreased, and LVESWS did not increase 
      significantly. FAC remained stable, and one patient developed RWMA. In the 
      laparoscopic group, LV end-diastolic area remained stable, and LVESWS increased. 
      FAC decreased significantly, and five patients developed RWMA. A decrease in 
      preload was the main important change in the laparotomy group, and in the 
      laparoscopic group a decrease in LV function was demonstrated that was likely a 
      consequence of decreased LV preload and increased LV afterload. However, these 
      did not necessitate stopping the procedure or releasing PTC in these study 
      patients without cardiac disease.
FAU - Decailliot, Francois
AU  - Decailliot F
AD  - *Service d'Anesthesie-Reanimation Chirurgicale and daggerService de Chirurgie 
      Digestive, Assistance Publique-Hopitaux de Paris Hopital Henri Mondor and 
      Universite Paris XII, Creteil, France.
FAU - Streich, Birgit
AU  - Streich B
FAU - Heurtematte, Yves
AU  - Heurtematte Y
FAU - Duvaldestin, Philippe
AU  - Duvaldestin P
FAU - Cherqui, Daniel
AU  - Cherqui D
FAU - Stephan, Francois
AU  - Stephan F
LA  - eng
PT  - Journal Article
PL  - United States
TA  - Anesth Analg
JT  - Anesthesia and analgesia
JID - 1310650
SB  - IM
MH  - Adult
MH  - Aged
MH  - *Cardiac Output
MH  - *Echocardiography, Transesophageal
MH  - Female
MH  - Humans
MH  - Laparoscopy
MH  - Male
MH  - Middle Aged
MH  - Myocardial Contraction
MH  - *Pneumoperitoneum, Artificial
MH  - Portal System/physiopathology
MH  - Prospective Studies
MH  - Ventricular Function, Left
EDAT- 2005/02/25 09:00
MHDA- 2005/03/19 09:00
CRDT- 2005/02/25 09:00
PHST- 2005/02/25 09:00 [pubmed]
PHST- 2005/03/19 09:00 [medline]
PHST- 2005/02/25 09:00 [entrez]
AID - 00000539-200503000-00002 [pii]
AID - 10.1213/01.ANE.0000144592.20499.12 [doi]
PST - ppublish
SO  - Anesth Analg. 2005 Mar;100(3):617-622. doi: 10.1213/01.ANE.0000144592.20499.12.