ISSN:
1432-1238
Keywords:
Key words Severe trauma
;
Myocardial dysfunction
;
Fractional area changes
;
Transesophageal echocardiography
Source:
Springer Online Journal Archives 1860-2000
Topics:
Medicine
Notes:
Abstract Objective:To evaluate cardiac function at the early phase of severe trauma. Design: Prospective, clinical study. Setting: Anesthesiological Intensive Care Unit. Patients: 7 consecutive patients admitted after severe trauma (ISS: 38±9, mean±SD), without preexisting cardiac disease. Interventions: Each patient received midazolam and sufentanyl for sedation. Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed. The fractional area change (FAC) of the left ventricle was calculated within 6 h following trauma and at day 1 and day 2 in order to evaluate left ventricular function. Measurements and results: All of the patients had a low FAC value 〈50% at day 0 (43.2±2.4%, range 39–46%), which increased significantly at day 2 (52.5±4%, range 47–59%, p=0.001), whereas heart rate and preload (assessed by left ventricular end diastolic area and pulmonary arterial occlusion pressure) were constant and afterload, assessed by systolic blood pressure, increased significantly between day 0 and day 2 (112±21 to 145±24 mmHg, p=0.02). Conclusion: The initial phase of severe trauma is associated with an abnormal cardiac function, suggested by a low FAC value. This myocardial dysfunction must be taken into account for early resuscitation after severe injury.
Type of Medium:
Electronic Resource
URL:
http://dx.doi.org/10.1007/BF01712161
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