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Left ventricular function after severe trauma

N Smaïl1, A Descorps Declère, J Duranteau

  • 1Centre Hospitalier Universitaire de Bicêtre, Département d'Anesthésie-Réanimation, Le Kremlin-Bicêtre, France.

Intensive Care Medicine
|May 1, 1996
PubMed
Summary
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Severe trauma impairs cardiac function, indicated by low fractional area change (FAC). This myocardial dysfunction requires consideration during early resuscitation efforts following severe injury.

Area of Science:

  • Cardiology
  • Trauma Medicine
  • Critical Care

Background:

  • Severe trauma can significantly impact multiple organ systems, including the cardiovascular system.
  • Early assessment of cardiac function is crucial for effective patient management.

Purpose of the Study:

  • To evaluate left ventricular function in the early phase following severe trauma.
  • To identify potential cardiac dysfunction using fractional area change (FAC).

Main Methods:

  • A prospective clinical study involving 7 severe trauma patients.
  • Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed.
  • Left ventricular fractional area change (FAC) was measured within 6 hours, and on days 1 and 2 post-trauma.

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Main Results:

  • Patients presented with low initial FAC (<50%), indicating impaired left ventricular function.
  • FAC significantly improved by day 2 (p=0.001).
  • Afterload (systolic blood pressure) increased significantly, while heart rate and preload remained constant.

Conclusions:

  • The early phase of severe trauma is characterized by abnormal cardiac function, evidenced by reduced FAC.
  • This myocardial dysfunction should be considered in the resuscitation strategy for severely injured patients.