Skip to main content
Erschienen in: Intensive Care Medicine 6/2004

01.06.2004 | Experimental

Monitoring of respiratory variations of aortic blood flow velocity using esophageal Doppler

verfasst von: Michel Slama, Henri Masson, Jean-Louis Teboul, Marie-Luce Arnould, Rachida Nait-Kaoudjt, Bouchra Colas, Marcel Peltier, Christophe Tribouilloy, Dinko Susic, Edward Frohlich, Michel Andréjak

Erschienen in: Intensive Care Medicine | Ausgabe 6/2004

Einloggen, um Zugang zu erhalten

Abstract

Objective

The purpose of this study was to determine whether monitoring of respiratory changes in aortic blood flow velocity, recorded by esophageal Doppler, could be used to detect changes in volume depletion.

Design

Animal study.

Animals and interventions

After general anesthesia and tracheotomy, ten New Zealand female rabbits, weighing 4–4.5 kg were studied under mechanical ventilation at a fixed tidal volume; during this time 5-ml blood samples were withdrawn (in increments up to a total of 30 ml) and then retransfused.

Measurements and results

At each step, systolic (SBP), diastolic (DBP), pulse (PP) pressures and maximum descending aortic blood flow (V) were recorded. Respiratory changes of V (ΔV), SBP (ΔSBP) and PP (ΔPP) were calculated as the difference of maximal and minimal values divided by their respective means and expressed as a percentage. The amount of blood withdrawn correlated negatively with SBP, DBP, PP and V and positively with ΔSBP, ΔPP and ΔV. Among these parameters, ΔV correlated best with the amount of blood withdrawn (r=0.89, p<0.001) and it was the most accurate index of volume depletion.

Conclusion

Monitoring of the respiratory variation in V, calculated by esophageal Doppler technique, seems to be a highly accurate index of blood volume depletion and restitution.
Literatur
1.
Zurück zum Zitat Slama M, Masson H, Teboul JL, Arnout ML, Susic D, Frohlich E, Andrejak M (2002) Respiratory variations of aortic VTI: a new index of hypovolemia and fluid responsiveness. Am J Physiol Heart Circ Physiol 283:H1729–1733PubMed Slama M, Masson H, Teboul JL, Arnout ML, Susic D, Frohlich E, Andrejak M (2002) Respiratory variations of aortic VTI: a new index of hypovolemia and fluid responsiveness. Am J Physiol Heart Circ Physiol 283:H1729–1733PubMed
2.
Zurück zum Zitat Perel A (1998) Assessing fluid responsiveness by the systolic pressure variation in mechanically ventilated patients. Anesthesiology 89:1309–1310PubMed Perel A (1998) Assessing fluid responsiveness by the systolic pressure variation in mechanically ventilated patients. Anesthesiology 89:1309–1310PubMed
3.
Zurück zum Zitat Berkenstadt H, Margalit N, Hadani M, Friedman Z, Segal E, Villa Y, Perel A (2001) Stroke volume variation as a predictor of fluid responsiveness in patients undergoing brain surgery. Anesth Analg 92:984–989PubMed Berkenstadt H, Margalit N, Hadani M, Friedman Z, Segal E, Villa Y, Perel A (2001) Stroke volume variation as a predictor of fluid responsiveness in patients undergoing brain surgery. Anesth Analg 92:984–989PubMed
4.
Zurück zum Zitat Tavernier B, Makhotine O, Lebuffe G, Dupont J, Scherpereel P (1998) Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology 89:1313–1321PubMed Tavernier B, Makhotine O, Lebuffe G, Dupont J, Scherpereel P (1998) Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology 89:1313–1321PubMed
5.
Zurück zum Zitat Coriat P, Vrillon M, Perel A, Baron JF, Le Bret F, Saada M, Viars P (1994) A comparison of systolic blood pressure variations and echocardiographic estimates of end-diastolic left ventricular size in patients after aortic surgery. Anesth Analg 78:46–53PubMed Coriat P, Vrillon M, Perel A, Baron JF, Le Bret F, Saada M, Viars P (1994) A comparison of systolic blood pressure variations and echocardiographic estimates of end-diastolic left ventricular size in patients after aortic surgery. Anesth Analg 78:46–53PubMed
6.
Zurück zum Zitat Michard F, Boussat S, Chemla D, Anguel N, Mercat A, Lecarpentier Y, Richard C, Pinsky MR, Teboul JL (2000) Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 162:134–138PubMed Michard F, Boussat S, Chemla D, Anguel N, Mercat A, Lecarpentier Y, Richard C, Pinsky MR, Teboul JL (2000) Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 162:134–138PubMed
7.
Zurück zum Zitat Feissel M, Michard F, Mangin I, Ruyer O, Faller JP, Teboul JL (2001) Respiratory changes in aortic blood velocity as an indicator of fluid responsiveness in ventilated patients with septic shock. Chest 119:867–873PubMed Feissel M, Michard F, Mangin I, Ruyer O, Faller JP, Teboul JL (2001) Respiratory changes in aortic blood velocity as an indicator of fluid responsiveness in ventilated patients with septic shock. Chest 119:867–873PubMed
8.
Zurück zum Zitat Tousignant CP, Walsh F, Mazer CD (2000) The use of transesophageal echocardiography for preload assessment in critically ill patients. Anesth Analg 90:351–355PubMed Tousignant CP, Walsh F, Mazer CD (2000) The use of transesophageal echocardiography for preload assessment in critically ill patients. Anesth Analg 90:351–355PubMed
9.
Zurück zum Zitat Cariou A, Monchi M, Joly LM, Bellenfant F, Claessens YE, Thebert D, Brunet F, Dhainaut JF (1998) Noninvasive cardiac output monitoring by aortic blood flow determination: evaluation of the Sometec Dynemo-3000 system. Crit Care Med 26:2066–2072 Cariou A, Monchi M, Joly LM, Bellenfant F, Claessens YE, Thebert D, Brunet F, Dhainaut JF (1998) Noninvasive cardiac output monitoring by aortic blood flow determination: evaluation of the Sometec Dynemo-3000 system. Crit Care Med 26:2066–2072
10.
Zurück zum Zitat Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476): 307–310PubMed Bland JM, Altman DG (1986) Statistical methods for assessing agreement between two methods of clinical measurement. Lancet 1(8476): 307–310PubMed
11.
Zurück zum Zitat Side CD, Gosling RG (1971) Non-surgical assessment of cardiac function. Nature 232:335–336PubMed Side CD, Gosling RG (1971) Non-surgical assessment of cardiac function. Nature 232:335–336PubMed
12.
Zurück zum Zitat Lavandier B, Cathignol D, Muchada R, Xuan BB, Motin J (1985) Noninvasive aortic blood flow measurement using an intraesophageal probe. Ultrasound Med Biol 11:451–460PubMed Lavandier B, Cathignol D, Muchada R, Xuan BB, Motin J (1985) Noninvasive aortic blood flow measurement using an intraesophageal probe. Ultrasound Med Biol 11:451–460PubMed
13.
Zurück zum Zitat Singer M, Clarke J, Bennett ED (1989) Continuous hemodynamic monitoring by esophageal Doppler. Crit Care Med 17:447–452PubMed Singer M, Clarke J, Bennett ED (1989) Continuous hemodynamic monitoring by esophageal Doppler. Crit Care Med 17:447–452PubMed
14.
Zurück zum Zitat Valtier B, Cholley BP, Belot JP, de la Coussaye JE, Mateo J, Payen DM (1998) Noninvasive monitoring of cardiac output in critically ill patients using transesophageal Doppler. Am J Respir Crit Care Med 158:77–83 Valtier B, Cholley BP, Belot JP, de la Coussaye JE, Mateo J, Payen DM (1998) Noninvasive monitoring of cardiac output in critically ill patients using transesophageal Doppler. Am J Respir Crit Care Med 158:77–83
15.
Zurück zum Zitat Perel A, Pizov R, Cotev S (1987) Systolic blood pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage. Anesthesiology 67:498–502PubMed Perel A, Pizov R, Cotev S (1987) Systolic blood pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage. Anesthesiology 67:498–502PubMed
16.
Zurück zum Zitat Reuter DA, Felbinger TW, Schmidt C, Kilger E, Goedje O, Lamm P, Goetz AE (2002) Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery. Intensive Care Med 28:392–398CrossRefPubMed Reuter DA, Felbinger TW, Schmidt C, Kilger E, Goedje O, Lamm P, Goetz AE (2002) Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery. Intensive Care Med 28:392–398CrossRefPubMed
17.
Zurück zum Zitat Michard F, Teboul JL (2002) Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest 121:2000–2008PubMed Michard F, Teboul JL (2002) Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest 121:2000–2008PubMed
18.
Zurück zum Zitat Jardin F, Farcot JC, Gueret P, Prost JF, Ozier Y, Bourdarias JP (1983) Cyclic changes in arterial pulse during respiratory support. Circulation 68:266–274 Jardin F, Farcot JC, Gueret P, Prost JF, Ozier Y, Bourdarias JP (1983) Cyclic changes in arterial pulse during respiratory support. Circulation 68:266–274
19.
Zurück zum Zitat Vieillard-Baron A, Loubieres Y, Schmitt JM, Page B, Dubourg O, Jardin F (1999) Cyclic changes in right ventricular output impedance during mechanical ventilation. J Appl Physiol 87:1644–1650 Vieillard-Baron A, Loubieres Y, Schmitt JM, Page B, Dubourg O, Jardin F (1999) Cyclic changes in right ventricular output impedance during mechanical ventilation. J Appl Physiol 87:1644–1650
20.
Zurück zum Zitat Vieillard-Baron A, Augarde R, Prin S, Page B, Beauchet A, Jardin F (2001) Influence of superior vena caval zone condition on cyclic changes in right ventricular outflow during respiratory support. Anesthesiology 95:1083–1088PubMed Vieillard-Baron A, Augarde R, Prin S, Page B, Beauchet A, Jardin F (2001) Influence of superior vena caval zone condition on cyclic changes in right ventricular outflow during respiratory support. Anesthesiology 95:1083–1088PubMed
Metadaten
Titel
Monitoring of respiratory variations of aortic blood flow velocity using esophageal Doppler
verfasst von
Michel Slama
Henri Masson
Jean-Louis Teboul
Marie-Luce Arnould
Rachida Nait-Kaoudjt
Bouchra Colas
Marcel Peltier
Christophe Tribouilloy
Dinko Susic
Edward Frohlich
Michel Andréjak
Publikationsdatum
01.06.2004
Verlag
Springer-Verlag
Erschienen in
Intensive Care Medicine / Ausgabe 6/2004
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-004-2190-z

Weitere Artikel der Ausgabe 6/2004

Intensive Care Medicine 6/2004 Zur Ausgabe

Update AINS

Bestellen Sie unseren Fach-Newsletter und bleiben Sie gut informiert.