Mori Y, Murakawa S, Asuma K, Yamada T, Hashimoto M, Hirose H
First Department of Surgery, School of Medicine, Gifu University, Japan.
Nihon Geka Gakkai Zasshi. 1993 Jun;94(6):625-30.
There are few reports on the assessment of the left ventricular function from left pressure-volume relationships intraoperatively in open heart surgery. LV Emax, Ea/Ees and EW/PVA efficiency were assessed intraoperatively by using a left ventricular conductance catheter in patients with aortocoronary bypass. After dobutamine administration (DOB, 10 micrograms/kg/min), LV Emax was increased by 33 +/- 23% during cardiopulmonary bypass (CPB) and 60 +/- 38% after weaning from CPB. Ea/Ees changed from 2.14 +/- 1.36 to 1.08 +/- 0.47 after weaning from CPB with dobutamine administration. EW/PVA efficiency changed from 52 +/- 12% to 66 +/- 10%. The change of LV Emax after dobutamine administration was correlated with the change of LV Emax after weaning from CPB and was correlated with Ea/Ees and EW/PVA efficiency after weaning from CPB. We concluded that measuring LV Emax before and after dobutamine administration during CPB is useful to assess left ventricular contraction clinically.
关于在心脏直视手术中通过左心室压力-容积关系评估左心室功能的报道较少。在接受主动脉冠状动脉搭桥术的患者中，术中使用左心室电导导管评估左心室Emax、Ea/Ees和EW/PVA效率。给予多巴酚丁胺（DOB，10微克/千克/分钟）后，体外循环（CPB）期间左心室Emax增加33±23%，脱离CPB后增加60±38%。给予多巴酚丁胺并脱离CPB后，Ea/Ees从2.14±1.36变为1.08±0.47。EW/PVA效率从52±12%变为66±10%。给予多巴酚丁胺后左心室Emax的变化与脱离CPB后左心室Emax的变化相关，且与脱离CPB后的Ea/Ees和EW/PVA效率相关。我们得出结论，在CPB期间给予多巴酚丁胺前后测量左心室Emax有助于临床评估左心室收缩功能。
