Evaluation of right ventricular performance using volumetric pulmonary artery catheter in patients undergoing off-pump coronary artery bypass grafting / 中华麻醉学杂志

ABSTRACT

Objective To evaluate the right ventricular function using volumetric pulmonary artery catheter (VPAC) in patients undergoing off-pump coronary artery bypass grafting (CABG) .Methods Thirty-two patients (18 males, 14 females) aged 45-63 yrs weighing 58-74 kg undergoing CABG were studied. Their cardiac functions were graded according to NYHA classification as Ⅰ or Ⅱ. Radial artery was cannulated before induction of anesthesia for BP monitoring. Anesthesia was induced with midazolam 0.03-0.05 mg?kg-1, fentanyl 10-15 ?g?kg-1 and pipecuronium 0.1-0.15 mg?kg-1 and maintained with 1.0-1.5% isoflurane. The probe (7 MHz) of the transesophageal echocardiography (TEE, Sonos 2500, HP) was placed in esophagus after tracheal intubation for measurement of both right and left ventricular end-diastolic, end-systolic volume and ejection fraction (LVEDV, LVESV, LVEF, RVEDV, RVESV, RVEF). VPAC (type 774HF75, Edwards Life Science Co) was placed via right internal jugular vein for measurement of RVEDV, RVESV and RVEF. 6% HAES 10 ml?kg-1 was infused over 10 min. The cardiovascular parameters mentioned above were measured before and immediately after 6% HAES infusion using both TEE and VPAC, and compared.Results The RVEDV and RVESV (measured by TEE and VPAC) and LVEDV, LVESV (by TEE) were significantly increased after HAES infusion as compared with the baseline values (P