Related Experiment Video
Updated: Jul 18, 2026
08:12
Invasive Hemodynamic Monitoring of Aortic and Pulmonary Artery Hemodynamics in a Large Animal Model of ARDS
Published on: November 26, 2018
Influence of acute preoperative hemodilution on right ventricular function
1Department of Anesthesiology and Intensive Care Medicine, Justus-Liebig-University, Giessen, FRG.
Journal of Cardiothoracic Anesthesia
|December 1, 1988
Summary
Acute preoperative hemodilution (HD) did not significantly alter right ventricular function in coronary artery surgery patients. This finding holds true even with reduced left ventricular function and significant right coronary artery stenosis, and after extracorporeal circulation.
Area of Science:
- Cardiovascular Surgery
- Anesthesiology
- Critical Care Medicine
Background:
- Patients undergoing coronary artery surgery often present with compromised left ventricular function and potential right coronary artery (RCA) stenosis.
- Preoperative hemodilution (HD) is a technique used to reduce blood loss, but its impact on right ventricular (RV) function in this specific patient population is not fully understood.
Purpose of the Study:
- To investigate the effects of acute, preoperative hemodilution on right ventricular function in patients with reduced left ventricular ejection fraction (<50%) and significant RCA stenosis.
- To compare the effects of hemodilution using hydroxyethyl starch (HES) versus Ringer's lactate (RL) on RV function.
- To assess RV function changes before and after hemodilution, and following extracorporeal circulation (ECC).
Main Methods:
- A randomized study involving 45 coronary artery surgery patients with reduced left ventricular function and significant RCA stenosis.
- Three groups were studied: hemodilution with HES (HD-HES, n=15), hemodilution with RL (HD-RL, n=15), and a control group without HD (n=15).
- Right ventricular end-diastolic volume (RVEDV), end-systolic volume (RVESV), and ejection fraction (RVEF) were measured using computerized thermodilution.
Main Results:
- Acute preoperative hemodilution did not significantly alter right ventricular systolic function (RVEF) in any of the study groups.
- Subsequent extracorporeal circulation did not impair the right ventricular function of the hemodiluted patients.
- Traditional pressure parameters did not correlate significantly with the thermodilution-derived right ventricular variables.
Conclusions:
- Moderate hemodilution is safe and does not compromise right ventricular function in patients undergoing coronary artery surgery, even with pre-existing left ventricular dysfunction and significant RCA stenosis.
- The choice of fluid (HES or RL) for hemodilution did not differentially affect right ventricular function in this context.
- Computerized thermodilution provides valuable RV function data that may not be reflected by standard pressure measurements.
Related Concept Videos
01:22Mitral Stenosis I: Introduction
Mitral Valve Stenosis (MVS) is a heart condition where the mitral valve narrows, impeding blood circulation from the left atrium to the left ventricle. The etiology and pathophysiology of this condition are multifaceted, leading to a cascade of cardiovascular complications.Causes of Mitral Valve StenosisRheumatic Heart Disease: It is the main cause of mitral valve stenosis, particularly in developing nations. This condition arises from rheumatic fever, an inflammatory illness resulting from...
01:20Mitral Regurgitation I: Introduction
Mitral regurgitation is characterized by the backward circulation of blood from the left ventricle to the left atrium during systole, a phase of the cardiac cycle when the heart contracts and pumps blood out of the chambers. This abnormal flow occurs primarily due to the dysfunction of the mitral valve or its supporting structures, which include the mitral leaflets, chordae tendineae, annulus, and papillary muscles.Etiology and Mechanisms:Primary Mitral Regurgitation: This type arises from...
01:28Cardiomyopathy VII: Pre and Post Operative Nursing Management
Patients with hypertrophic cardiomyopathy (HCM) and left ventricular outflow tract (LVOT) obstruction who remain symptomatic despite optimal medical therapy may undergo a septal myectomy (Morrow procedure). This procedure involves excising a portion of the hypertrophied septum below the aortic valve using a heart-lung machine to improve blood flow through the LVOT. Effective preoperative and postoperative nursing management ensures successful patient outcomes, minimizes complications, and...
01:26Imbalances in Cardiac Output
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send blood...
01:21Cardiac Catheterization II: Right Heart Catheterization
Right Heart Catheterization: An OverviewRight heart catheterization is an invasive diagnostic procedure that measures right-sided cardiac and pulmonary artery pressures, calculates cardiac output, and identifies intracardiac shunts. It provides detailed hemodynamic data essential for diagnosing and managing various cardiovascular conditions, such as pulmonary hypertension.Access SitesCommon access sites for right heart catheterization include the internal jugular vein in the neck region, the...
01:28Cardiac Catheterization I: Pre-Procedure Overview
Cardiac catheterization is an invasive diagnostic technique used to identify and evaluate structural and functional diseases of the heart and major blood vessels. This technique diagnoses congenital heart disease, coronary artery disease, valvular heart disease, and coronary spasms and assesses ventricular function. It helps guide treatment decisions, including the need for revascularization procedures like percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and...