Assessment of cardiac preload by indicator dilution and transoesophageal echocardiography

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Background and objectiveAssessment of cardiac preload is of major importance in the management of critically ill patients. Echocardiographic determined left ventricular end-diastolic area and indicator dilution derived intrathoracic blood volume are used as surrogates for cardiac preload. However, no controlled comparison studies on the relationship between induced changes in end-diastolic area and intrathoracic blood volume and concomitant changes in stroke volume index are available.MethodsThe effects of a change in body position on these variables were investigated in 10 anaesthetized patients.ResultsIntrathoracic blood volume and end-diastolic area decreased by 18 ± 11% and 27 ± 13 % respectively. Stroke volume index concomitantly decreased by 19 ± 11 %. Correlation analysis revealed a close relation between stroke volume index and intrathoracic blood volume (r =0.75) and end-diastolic area (r =0.76).ConclusionsWithin the observed range of data, intrathoracic blood volume and end-diastolic area are equivalent indices of cardiac preload.

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