Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica

Acta Academiae Medicinae Sinica ›› 2015, Vol. 37 ›› Issue (3): 331-334.doi: 10.3881/j.issn.1000-503X.2015.03.016

• Orginal Article • Previous Articles     Next Articles

Hemodynamic Changes in Patients Undergoing Pericardiectomy

Xia RUAN, Wei LIU(), Li-jian PEI, Guang-jun CHEN, Jing-jie WANG, Yu-guang HUANG()   

  1. Department of Anesthesiology,PUMC Hospital,CAMS and PUMC,Beijing 100730,China
  • Received:2014-06-09 Online:2015-05-23 Published:2015-06-30

Abstract: Objective

To observe the hemodynamic changes in patients undergoing pericardiectomy at different operational stages.

Methods

Totally 16 consecutive patients receiving radical pericardiectomy were enrolled in this observational study. Hemodynamic variables were monitored continuously by pulse-indicated continuous cardiac output(PiCCO)system. Totally,three sets of intraoperative hemodynamic parameters were obtained at three different stages of pericardiectomy.

Results

During the pericardiectomy,the cardiac index[CI,(1.9±0.6),(2.7±0.6),(3.0±0.5)L·min-1·m-2;P<0.05]and stroke volume index[SI,(22.5±8.7),(29.9±8.5),(30.1±8.5)dyn·s·cm-5·m2;P<0.05]showed significant improvement,whereas central venous pressure[CVP,(17.1±5.0),(13.3±3.9),(12.3±3.0)mmHg;P<0.05]decreased significantly. Global end-diastolic volume index[GEDVi,(533±156),(580±153),(559±144)ml·m-2;P<0.05]increased and stroke volume variation[SVV,(15.6±6.1)%,(10.8±4.2)%,(9.4±5.4)%;P<0.05]decreased intra-operatively. The majority of the above-mentioned hemodynamic improvements occurred after the resection of pericardium over the left ventricular outflow tract(LVOT).

Conclusions

PiCCO system can serve as a reliable,less invasive hemodynamic monitoring method during pericardiectomy. Resection of the pericardium over the LVOT is the most important step of the pericardiectomy.

Key words: pericardiectomy, pulse-indicated continuous cardiac output, hemodynamics

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