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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2014 November;80(11):1169-77
Experimental validation of frequently-used echocardiographic right-ventricular impedance parameters
Reis Miranda D. 1, Marco Knook A. H. 1, Paalvast F. 1, Rossi A. 2, Hop W. 3, Oei F. 4, Van Bommel J. 1, Gommers D. 1 ✉
1 Department of Intensive Care, Erasmus Medical Centre, Rotterdam, The Netherlands;
2 Department of Radiology, Erasmus Medical Centre, Rotterdam, The Netherlands;
3 Department of Biostatistics, Erasmus Medical Centre, Rotterdam, The Netherlands;
4 Department of Cardiothoracic Surgery, Erasmus Medical Centre, Rotterdam, The Netherlands
BACKGROUND: Aim of the study was to validate commonly used bedside right-ventricular (RV) impedance parameters, which are utilized in determining heart-lung interactions during mechanical ventilation.
METHODS: Fifteen pigs were equally assigned to either an open or a closed pericardium group. In all animals, an inflatable vascular occluder and a flow probe were placed around the main pulmonary artery, which allowed for a gradual increase in pulmonary vascular impedance with banding of the pulmonary artery. A median sternotomy was performed for the open pericardium group, and a lateral thoracotomy was performed for the closed pericardium group.
RESULTS: In the open pericardium group, mean acceleration time (ACmean) and the slope of the pulmonary artery flow correlated significantly with Poiseuille resistance over the banding (r=0.67 and r=0.65, respectively). In the closed pericardium group, the ratio of the right to left ventricular area, eccentricity index, and tricuspid annular plane systolic excursion did not correlate with resistance over the banding, only the ACmean showed a significant correlation with resistance over the banding (r=0.88).
CONCLUSION: ACmean is a reliable parameter of RV impedance that can be used to study the heart-lung interactions during mechanical ventilation.