Trendelenburg position and passive leg raising do not significantly improve cardiopulmonary performance in the anesthetized patient with coronary artery disease.

Abstract:

:The effects of the Trendelenburg (TREND) position and passive straight leg raising (PLR) on cardiopulmonary performance in 18 anesthetized patients undergoing myocardial revascularization were studied with a two-dimensional transesophageal echocardiography probe and a thermodilution right ventricular ejection fraction (RVEF) pulmonary artery catheter. The TREND position (at 20 degrees) and PLR (at 60 degrees) were studied in relation to the level-supine position in random order. At 3 min, the TREND caused significant (p less than .05) decreases in heart rate (62 +/- 9 to 58 +/- 10 [SD] beat/min) and RVEF (0.48 +/- 0.11 to 0.44 +/- 0.10), and significant increases in mean arterial pressure (77 +/- 11 to 82 +/- 11 mm Hg), mean pulmonary artery pressure (16 +/- 4.3 to 19 +/- 5.5 mm Hg), wedge pressure (11 +/- 4 to 13 +/- 4 mm Hg), cardiac index (CI) (2.36 +/- 0.79 to 2.52 +/- 0.93 L/min.m2), right ventricular end-systolic volume index (44 +/- 21 to 58 +/- 21 ml/m2), right ventricular end-diastolic volume index (83 +/- 24 to 102 +/- 22 ml/m2), and shunt fraction (0.16 +/- 0.06 to 0.19 +/- 0.06). CVP and left ventricular areas did not change significantly. PLR had similar effects as the TREND position, except CI did not change significantly. Thus, the TREND and PLR resulted in minor hemodynamic improvement with right ventricular dilation, decreased RVEF, and impaired oxygenation in the anesthetized cardiac surgical patient.

journal_name

Crit Care Med

journal_title

Critical care medicine

authors

Reich DL,Konstadt SN,Raissi S,Hubbard M,Thys DM

doi

10.1097/00003246-198904000-00003

subject

Has Abstract

pub_date

1989-04-01 00:00:00

pages

313-7

issue

4

eissn

0090-3493

issn

1530-0293

journal_volume

17

pub_type

临床试验,杂志文章,随机对照试验
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    pub_type: 指南,杂志文章,实务指引

    doi:

    authors:

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    pub_type: 杂志文章

    doi:

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    pub_type: 杂志文章,随机对照试验

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    更新日期:2007-11-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/00003246-198904000-00002

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    更新日期:2017-10-01 00:00:00

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    更新日期:1997-09-01 00:00:00

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    更新日期:2000-03-01 00:00:00

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    pub_type: 临床试验,杂志文章

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    更新日期:2000-02-01 00:00:00

  • System for umbilical artery monitoring.

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  • Improving Survival of Critical Care Patients With Coronavirus Disease 2019 in England: A National Cohort Study, March to June 2020.

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    pub_type: 杂志文章

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    更新日期:1995-09-01 00:00:00

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    pub_type: 杂志文章,评审

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    更新日期:2008-04-01 00:00:00

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    更新日期:2013-05-01 00:00:00

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    更新日期:2013-09-01 00:00:00

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    更新日期:2000-12-01 00:00:00

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    pub_type: 杂志文章

    doi:10.1097/CCM.0B013E31816443CB

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    更新日期:2009-04-01 00:00:00

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