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Related Experiment Videos

Right ventricular function in human sepsis: a thermodilution study

J F Dhainaut1, M R Pinsky, S Nouria

  • 1Medical ICU, Cochin Port-Royal Hospital, University of Paris V, France.

Chest
|October 23, 1997
PubMed
Summary
This summary is machine-generated.

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In sepsis, right ventricular end-diastolic volume and end-systolic volume change independently of pressure. Changes in right ventricular end-diastolic volume directly correlate with end-systolic volume, indicating a compliant chamber.

Area of Science:

  • Cardiology
  • Critical Care Medicine
  • Physiology

Background:

  • Sepsis can lead to significant cardiovascular dysfunction.
  • Understanding right ventricular (RV) pressure-volume relationships is crucial for managing sepsis-induced hemodynamic instability.
  • The RV's behavior in sepsis remains incompletely characterized.

Purpose of the Study:

  • To investigate the relationship between right ventricular (RV) pressures and volumes in patients with sepsis.
  • To determine how changes in RV preload and afterload affect RV function during sepsis.

Main Methods:

  • Prospective study conducted in an Intensive Care Unit (ICU).
  • Eighteen hemodynamically stable sepsis patients underwent stepwise changes in RV end-diastolic volume (EDV) using military antishock trousers (MAST).

Related Experiment Videos

  • RV pressures and volumes were measured using a pulmonary arterial catheter, calculating RV ejection fraction (RVEF), RV end-systolic volume (ESV), and stroke volume (SV).

    • Main Results:

    • MAST inflation to 30 and 50 mm Hg increased right atrial pressure (Pra), pulmonary artery pressures (Ppa), RV EDV, and RV ESV, while SV and RVEF remained unchanged.
    • Correlations between Pra and EDV, and between Ppa and ESV, were poor.
    • Absolute and relative changes in RV EDV closely corresponded with respective RV ESV values (r=0.93).

    Conclusions:

    • In sepsis, RV EDV and ESV vary independently of changes in right atrial pressure and ejection pressure.
    • The RV appears to be a highly compliant chamber during filling in sepsis, with changes in EDV proportionally altering ESV.
    • The RV's ejection efficiency (RVEF) is not directly related to changes in RV pressures during sepsis.