Portal Vein Pulsatility as a Dynamic Marker ...
Document type :
Article dans une revue scientifique
DOI :
Permalink :
Title :
Portal Vein Pulsatility as a Dynamic Marker of Venous Congestion Following Cardiac Surgery: An Interventional Study Using Positive End-Expiratory Pressure
Author(s) :
Huette, Pierre [Auteur]
Département d'anesthésiologie [CHU Caen]
Guinot, Pierre-Gregoire [Auteur]
Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer [LabEx LipSTIC]
Lipides - Nutrition - Cancer [Dijon - U1231] [LNC]
Service d'anesthésie - réanimation chirurgicale [CHU de Dijon]
Haye, Guillaume [Auteur]
Moussa, Mouhamed Djahoum [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Beyls, Christophe [Auteur]
CHU Amiens-Picardie
Guilbart, Mathieu [Auteur]
Martineau, Lucie [Auteur]
Université de Picardie Jules Verne [UPJV]
Dupont, Herve [Auteur]
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
CHU Amiens-Picardie
Mahjoub, Yazine [Auteur]
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
Service de dermatologie [CHU d'Amiens-Picardie]
Abou-Arab, Osama [Auteur]
CHU Amiens-Picardie
Département d'anesthésiologie [CHU Caen]
Guinot, Pierre-Gregoire [Auteur]
Laboratoire d'Excellence : Lipoprotéines et Santé : prévention et Traitement des maladies Inflammatoires et du Cancer [LabEx LipSTIC]
Lipides - Nutrition - Cancer [Dijon - U1231] [LNC]
Service d'anesthésie - réanimation chirurgicale [CHU de Dijon]
Haye, Guillaume [Auteur]
Moussa, Mouhamed Djahoum [Auteur]
Récepteurs Nucléaires, Maladies Métaboliques et Cardiovasculaires - U1011 [RNMCD]
Beyls, Christophe [Auteur]
CHU Amiens-Picardie
Guilbart, Mathieu [Auteur]
Martineau, Lucie [Auteur]
Université de Picardie Jules Verne [UPJV]
Dupont, Herve [Auteur]
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
CHU Amiens-Picardie
Mahjoub, Yazine [Auteur]
Mécanismes physiopathologiques et conséquences des calcifications vasculaires - UR UPJV 7517 [MP3CV]
Service de dermatologie [CHU d'Amiens-Picardie]
Abou-Arab, Osama [Auteur]
CHU Amiens-Picardie
Journal title :
JOURNAL OF CLINICAL MEDICINE
Publication date :
2021
HAL domain(s) :
Sciences du Vivant [q-bio]
English abstract : [en]
We aimed to assess variations in the portal vein pulsatility index (PI) during mechanical ventilation following cardiac surgery. Method. After ethical approval, we conducted a prospective monocentric study at Amiens ...
Show more >We aimed to assess variations in the portal vein pulsatility index (PI) during mechanical ventilation following cardiac surgery. Method. After ethical approval, we conducted a prospective monocentric study at Amiens University Hospital. Patients under mechanical ventilation following cardiac surgery were enrolled. Doppler evaluation of the portal vein (PV) was performed by transthoracic echography. The maximum velocity (VMAX) and minimum velocity (VMIN) of the PV were measured in pulsed Doppler mode. The PI was calculated using the following formula (VMAX - VMIN)/(VMax). A positive end-expiratory pressure (PEEP) incremental trial was performed from 0 to 15 cmH(2)O, with increments of 5 cmH(2)O. The PI (%) was assessed at baseline and PEEP 5, 10, and 15 cmH(2)O. Echocardiographic and hemodynamic parameters were recorded. Results. In total, 144 patients were screened from February 2018 to March 2019 and 29 were enrolled. Central venous pressure significantly increased for each PEEP increment. Stroke volumes were significantly lower after PEEP incrementation, with 52 mL (50-55) at PEEP 0 cmH(2)O and 30 mL (25-45) at PEEP 15 cmH(2)O, (p < 0.0001). The PI significantly increased with PEEP incrementation, from 9% (5-15) at PEEP 0 cmH(2)O to 15% (5-22) at PEEP 5 cmH(2)O, 34% (23-44) at PEEP 10 cmH(2)O, and 45% (25-49) at PEEP 15 cmH(2)O (p < 0.001). Conclusion. In the present study, PI appears to be a dynamic marker of the interaction between mechanical ventilation and right heart pressure after cardiac surgery. The PI could be a useful noninvasive tool to monitor venous congestion associated with mechanical ventilation.Show less >
Show more >We aimed to assess variations in the portal vein pulsatility index (PI) during mechanical ventilation following cardiac surgery. Method. After ethical approval, we conducted a prospective monocentric study at Amiens University Hospital. Patients under mechanical ventilation following cardiac surgery were enrolled. Doppler evaluation of the portal vein (PV) was performed by transthoracic echography. The maximum velocity (VMAX) and minimum velocity (VMIN) of the PV were measured in pulsed Doppler mode. The PI was calculated using the following formula (VMAX - VMIN)/(VMax). A positive end-expiratory pressure (PEEP) incremental trial was performed from 0 to 15 cmH(2)O, with increments of 5 cmH(2)O. The PI (%) was assessed at baseline and PEEP 5, 10, and 15 cmH(2)O. Echocardiographic and hemodynamic parameters were recorded. Results. In total, 144 patients were screened from February 2018 to March 2019 and 29 were enrolled. Central venous pressure significantly increased for each PEEP increment. Stroke volumes were significantly lower after PEEP incrementation, with 52 mL (50-55) at PEEP 0 cmH(2)O and 30 mL (25-45) at PEEP 15 cmH(2)O, (p < 0.0001). The PI significantly increased with PEEP incrementation, from 9% (5-15) at PEEP 0 cmH(2)O to 15% (5-22) at PEEP 5 cmH(2)O, 34% (23-44) at PEEP 10 cmH(2)O, and 45% (25-49) at PEEP 15 cmH(2)O (p < 0.001). Conclusion. In the present study, PI appears to be a dynamic marker of the interaction between mechanical ventilation and right heart pressure after cardiac surgery. The PI could be a useful noninvasive tool to monitor venous congestion associated with mechanical ventilation.Show less >
Language :
Anglais
Peer reviewed article :
Oui
Audience :
Internationale
Popular science :
Non
Source :
Submission date :
2022-02-16T04:01:34Z