Skip Navigation LinksHome > August 1988 - Volume 69 - Issue 2 > Acute Left Ventricular Dysfunction during Unsuccessful Weani...
Anesthesiology:
ORIGINAL ARTICLES: PDF Only

Acute Left Ventricular Dysfunction during Unsuccessful Weaning from Mechanical Ventilation.

Lemaire, Francois M.D.; Teboul, Jean-Louis; Cinotti, Luc M.D.; Giotto, Guillen M.D.; Abrouk, Fekri M.D.; Steg, Gabriel M.D.; Macquin-Mavier, Isabelle M.D.; Zapol, Warren M. M.D.

Collapse Box

Abstract

The authors studied the hemodynamic effects of rapidly weaning from mechanical ventilation (MV) 15 patients with severe chronic obstructive pulmonary disease (COPD) and cardiovascular disease who were recovering from acute cardiopulmonary decompensation. In each patient, 10 min of spontaneous ventilation (SV) with supplemental oxygen resulted in reducing the mean esophageal pressure (X +/- SD, + 5 +/- 3 to -2 +/- 2.5 mmHg, P < .01 and increasing cardiac index (CI) 3.2 +/- 0.9 to 4.3 +/- 1.3 I/min/M2, P < .001), systemic blood pressure (BP 77 +/- 12 to 90 +/- 11 mmHg, P < .001), heart rate (HR 97 +/- 12 to 112 +/- 16 beats/min, P < .001), and most importantly, transmural pulmonary artery occlusion pressure markedly increased (PAOPtm 8 +/- 5 to 25 +/- 13 mmHg, P < .001), mandating a reinstitution of MV. In four patients with left ventricular (LV) catheters, the PAOP correlated with the LV end-diastolic pressure during both MV and SV. Gated blood pool imaging showed SV increased the LV end-diastolic volume index (65 +/- 24 to 83 +/- 32/M2, P < .002) with LV ejection fraction unchanged. patients were treated for a mean of 10 days with diuretics, resulting in a reduction of blood volume (4.55 +/- 0.9 I to 3.56 +/- 0.55 I) and body weight (-5 kg, P < .001). Subsequently, nine of the 15 patients were weaned successfully from mechanical ventilation with unchanged PAOP.
(C) 1988 American Society of Anesthesiologists, Inc.
Publication of an advertisement in Anesthesiology Online does not constitute endorsement by the American Society of Anesthesiologists, Inc. or Lippincott Williams & Wilkins, Inc. of the product or service being advertised.
Login

Article Tools

Share

Search for Similar Articles
You may search for similar articles that contain these same keywords or you may modify the keyword list to augment your search.