Right ventricular end-diastolic volume monitoring after cardiac surgery

Toru Ishida, Takeshi Lee, Takashi Shimabukuro, Hiroshi Niinami
Annals of Thoracic and Cardiovascular Surgery 2004, 10 (3): 167-70

INTRODUCTION: In the postoperative management of cardiac surgery patients, pulmonary capillary wedge pressure (PCWP) and central venous pressure (CVP) are the most commonly used parameters of preload. However, these pressure parameters are easily affected by ventricular compliance, positive end-expiratory pressure and other factors. The aim of this study was to evaluate whether right ventricular end-diastolic volume index (RVEDVI) reflects cardiac output or ventricular preload in patients after cardiac surgery during postoperative management.

METHODS: We performed measurements in 31 patients postoperatively in the intensive care unit every 1 or 2 hours using a modified thermodilution catheter.

RESULTS: There were 999 measured hemodynamic data sets and the measurement duration was 47 +/- 21 hours (mean +/- SD). RVEDVI was 119 +/- 32 ml/m(2), cardiac index (CI) was 2.7 +/- 0.7 L/min/m(2), and PCWP was 11 +/- 4 mmHg. A significant correlation was found between RVEDVI, CVP and CI in 15 of 31 patients, and between PCWP and CI in 4 of 22 patients. In 33% of cases, CVP showed a negative correlation with CI, whereas 7% showed a negative correlation between RVEDVI and CI.

CONCLUSION: RVEDVI was a significant index during the postoperative management after cardiac surgery.

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