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[Hemodynamic changes during pneumonectomy especially changes of right ventricular ejection fraction]

Y Shiraishi1, K Tanimura, T Mochizuki

  • 1Department of Anesthesia, Shizuoka General Hospital.

Masui. the Japanese Journal of Anesthesiology
|January 1, 1993
PubMed
Summary

Right ventricular ejection fraction (RVEF) effectively monitors hemodynamic changes during pneumonectomy. This rapid measurement aids in assessing right ventricular afterload and can guide surgical decisions.

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Area of Science:

  • Cardiovascular Physiology
  • Thoracic Surgery
  • Critical Care Medicine

Context:

  • Pneumonectomy, a major thoracic surgery, carries significant hemodynamic risks.
  • Monitoring right ventricular function is crucial during and after pulmonary artery manipulation.
  • Assessing perioperative hemodynamic stability is essential for patient outcomes.

Purpose:

  • To evaluate the utility of rapid computerized thermodilution for measuring right ventricular ejection fraction (RVEF) during pneumonectomy.
  • To assess hemodynamic changes, specifically right ventricular afterload, in patients undergoing pneumonectomy.
  • To determine if RVEF can serve as a reliable indicator for managing pneumonectomy.

Summary:

  • Hemodynamic parameters, including RVEF, pulmonary artery resistance index (PVRI), and stroke volume index (SVI), were monitored in 14 patients during pneumonectomy.

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  • A significant increase in right ventricular afterload was observed 10 minutes after pulmonary artery clamping.
  • RVEF demonstrated a rapid response to changes in right ventricular afterload, suggesting its utility as a monitoring tool.

    • Impact:

    • Rapid computerized thermodilution provides a fast and responsive method for monitoring RVEF during pneumonectomy.
    • RVEF measurements can aid clinicians in assessing and managing right ventricular afterload in real-time.
    • Findings suggest RVEF may be a valuable safety index to guide pneumonectomy indications and perioperative management.