OBJECTIVE: To evaluate cardiac function at the early phase of severe trauma. DESIGN: Prospective, clinical study. SETTING: Anesthesiological Intensive Care Unit. PATIENTS: 7 consecutive patients admitted after severe trauma (ISS: 38 +/- 9, mean +/- SD), without preexisting cardiac disease. INTERVENTIONS: Each patient received midazolam and sufentanyl for sedation. Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed. The fractional area change (FAC) of the left ventricle was calculated within 6 h following trauma and at day 1 and day 2 in order to evaluate left ventricular function. MEASUREMENTS AND RESULTS: All of the patients had a low FAC value < 50% at day 0 (43.2 +/- 2.4%, range 39-46%), which increased significantly at day 2 (52.5 +/- 4%, range 47-59%, p = 0.001), whereas heart rate and preload (assessed by left ventricular end diastolic area and pulmonary arterial occlusion pressure) were constant and afterload, assessed by systolic blood pressure, increased significantly between day 0 and day 2 (112 +/- 21 to 145 +/- 24 mmHg, p = 0.02). CONCLUSION: The initial phase of severe trauma is associated with an abnormal cardiac function, suggested by a low FAC value. This myocardial dysfunction must be taken into account for early resuscitation after severe injury.
OBJECTIVE: To evaluate cardiac function at the early phase of severe trauma. DESIGN: Prospective, clinical study. SETTING: Anesthesiological Intensive Care Unit. PATIENTS: 7 consecutive patients admitted after severe trauma (ISS: 38 +/- 9, mean +/- SD), without preexisting cardiac disease. INTERVENTIONS: Each patient received midazolam and sufentanyl for sedation. Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed. The fractional area change (FAC) of the left ventricle was calculated within 6 h following trauma and at day 1 and day 2 in order to evaluate left ventricular function. MEASUREMENTS AND RESULTS: All of the patients had a low FAC value < 50% at day 0 (43.2 +/- 2.4%, range 39-46%), which increased significantly at day 2 (52.5 +/- 4%, range 47-59%, p = 0.001), whereas heart rate and preload (assessed by left ventricular end diastolic area and pulmonary arterial occlusion pressure) were constant and afterload, assessed by systolic blood pressure, increased significantly between day 0 and day 2 (112 +/- 21 to 145 +/- 24 mmHg, p = 0.02). CONCLUSION: The initial phase of severe trauma is associated with an abnormal cardiac function, suggested by a low FAC value. This myocardial dysfunction must be taken into account for early resuscitation after severe injury.
Authors: Ursula Muller-Werdan; Michael Buerke; Henning Ebelt; Konstantin M Heinroth; Anja Herklotz; Harald Loppnow; Martin Ruß; Frithjof Schlegel; Axel Schlitt; Hendrik B Schmidt; Gerold Söffker; Karl Werdan Journal: Exp Clin Cardiol Date: 2006
Authors: Andrea Pasquale Cossu; Paolo Mura; Lorenzo Matteo De Giudici; Daniela Puddu; Laura Pasin; Maurizio Evangelista; Theodoros Xanthos; Mario Musu; Gabriele Finco Journal: Biomed Res Int Date: 2014-09-01 Impact factor: 3.411
Authors: François Beloncle; Ferhat Meziani; Nicolas Lerolle; Peter Radermacher; Pierre Asfar Journal: Ann Intensive Care Date: 2013-05-22 Impact factor: 6.925