Settergren G, Samuelson S, Owall A, Brodin L A, Juhlin-Dannfelt A, Liska J
Department of Cardiothoracic Anaesthetics and Intensive Care, Karolinska Hospital, Stockholm, Sweden.
J Cardiothorac Vasc Anesth. 1993 Jun;7(3):290-3. doi: 10.1016/1053-0770(93)90007-8.
Twenty patients (age 45 to 78 years) were studied with ethical committee approval and informed patient consent during coronary artery bypass grafting. Transesophageal echocardiography (TEE) was used to validate a clinical measure of preload: inspection of the line of contact between the heart (acute margin) and the diaphragm. Immediately before going on cardiopulmonary bypass (CPB), with the cannulas and stay sutures in place, a small mark was made with the cautery on the diaphragm at the line of contact. After CPB the patients were transfused from the extracorporeal circuit to exactly the same level. At these two times, TEE recordings of the short axis of the left ventricle were performed and stored on videotape for later blinded evaluation off-line. The left ventricle short-axis area in end-diastole measured after CPB showed a close correlation to that measured before CPB, r = 0.88, P < 0.001. The regression line was close to the line of identity. The conclusion was that inspection of the line of contact between the heart and the diaphragm can be used clinically during weaning from bypass to obtain the same left ventricular end-diastolic volume as before CPB.
在冠状动脉搭桥手术期间，经伦理委员会批准并获得患者知情同意后，对20例患者（年龄45至78岁）进行了研究。经食管超声心动图（TEE）用于验证一项前负荷的临床测量方法：检查心脏（急性边缘）与膈肌之间的接触线。在即将进行体外循环（CPB）之前，在插管和固定缝线就位的情况下，用电灼器在膈肌上的接触线处做一个小标记。CPB后，患者从体外循环回路输血至完全相同的水平。在这两个时间点，对左心室短轴进行TEE记录，并存储在录像带上，以便之后进行离线盲法评估。CPB后测量的舒张末期左心室短轴面积与CPB前测量的结果密切相关，r = 0.88，P < 0.001。回归线接近恒等线。结论是，在脱离体外循环期间，检查心脏与膈肌之间的接触线可在临床上用于获得与CPB前相同的左心室舒张末期容积。
