Reduced Intrathoracic Blood Volume and Left and Right Ventricular Dimensions in Patients With Severe Emphysema

CHEST Journal ◽  
2007 ◽  
Vol 131 (4) ◽  
pp. 1050-1057 ◽  
Author(s):  
Kirsten Jörgensen ◽  
Markus F. Müller ◽  
Jacqueline Nel ◽  
Richard N. Upton ◽  
Erik Houltz ◽  
...  
1982 ◽  
Vol 242 (4) ◽  
pp. H549-H556 ◽  
Author(s):  
S. S. Cassidy ◽  
J. H. Mitchell ◽  
R. L. Johnson

Our purpose was to determine the effects of controlled ventilation with positive end-expired pressure (PEEP) on ventricular dimensions and to relate changes in shape to changes in stroke volume and left ventricular volumes. Left and right ventricular dimensions were measured using biplane cinefluorography of dogs with radiopaque markers implanted in their hearts, and left ventricular volumes were derived from left ventricular dimensions by assuming that the left ventricle conformed to the shape of a nonprolate ellipsoid. As PEEP increased from 0 to 5, 10, and 15 cmH2O, stroke volume fell 36%, and all three left ventricular end-diastolic dimensions fell, with apex-base falling 5%, anterior-posterior falling 7%, and septal-lateral falling nearly twice as much, 12%. This resulted in a 11.3 cm3 fall in left ventricular end-diastolic volume. The right ventricular end-diastolic dimensions changed in opposite directions with respect to each other as the level and PEEP was raised to 15 cmH2O; one axis fell 3.2 mm, and the midpoint of the right ventricular free wall moved outward by 1.7 mm. Thus the fall in cardiac output (and stroke volume) during PEEP was associated with a fall in left ventricular end-diastolic volume and a change both left and right ventricular configurations. It is not known whether the left ventricular septal-lateral narrowing is the consequence of lateral wall compression by the lungs or encroachment on the left ventricle by the septum.


1978 ◽  
Vol 235 (2) ◽  
pp. H231-H236 ◽  
Author(s):  
I. Mashiro ◽  
J. N. Cohn ◽  
R. Heckel ◽  
R. R. Nelson ◽  
J. A. Franciosa

Ventricular dimensions by surface echocardiography and intraventricular pressures were monitored in 27 dogs before and during ventricular fibrillation (VF) induced by coronary embolization (nine dogs), potassium infusion (nine dogs) and calcium infusion (nine dogs). Left ventricular diameter (LVD) fell by an average of 10.3 mm during the first 30 s after the onset of VF induced by ischemia or potassium and remained smaller than the prefibrillation end-diastolic LVD during the ensuing 10 min. LVD fell during calcium infusion, and after the onset of VF it remained only slightly larger than the preinfusion end-systolic LVD. Right ventricular (RV) diameter increased progressively for the first 2 min during VF an average of 15.9 mm. The failure of LV size to increase during VF was explained by a pressure gradient inhibiting LV filling during the early phase of VF. Despite progressive RV filling, pressure in the more compliant RV remained lower than in the LV, which exhibited reduced compliance during VF. Therefore, cardiac dilation during VF appears to be confined to the RV, and inhibition to LV filling is an important feature of the syndrome.


2002 ◽  
Vol 283 (4) ◽  
pp. H1729-H1733 ◽  
Author(s):  
Michel Slama ◽  
Henri Masson ◽  
Jean-Louis Teboul ◽  
Marie-Luce Arnout ◽  
Dinko Susic ◽  
...  

In 12 mechanically ventilated and anesthetized rabbits, we investigated whether the magnitude of respiratory changes in the aortic velocity time integral (VTIAo), recorded by transthoracic echocardiography (TTE) during a stepwise blood withdrawal and restitution, could be used as a reliable indicator of volume depletion and responsiveness. At each step, left and right ventricular dimensions and the aortic diameter and VTIAo were recorded to calculate stroke volume (SV) and cardiac output (CO). Respiratory changes of VTIAo(maximal − minimal values divided by their respective means) were calculated. The amount of blood withdrawal correlated negatively with left and right ventricular diastolic diameters, VTIAo, SV, and CO and correlated directly with respiratory changes of VTIAo. Respiratory VTIAo variations (but not other parameters) at the last blood withdrawal step was also correlated with changes in SV after blood restitution ( r = 0.83, P < 0.001). In conclusion, respiratory variations in VTIAo using TTE appear to be a sensitive index of blood volume depletion and restitution. This dynamic parameter predicted fluid responsiveness more reliably than static markers of cardiac preload.


2012 ◽  
Vol 58 (1) ◽  
pp. 41-47 ◽  
Author(s):  
Mirella Pessoa Sant’Anna ◽  
Roberto José Vieira de Mello ◽  
Luciano Tavares Montenegro ◽  
Mônica Modesto Araújo

2015 ◽  
Vol 18 (5) ◽  
pp. 184 ◽  
Author(s):  
Makoto Mori ◽  
Soh Hosoba ◽  
Stephanie Yoshimura ◽  
Omar Lattouf

<p>Mural endocarditis is an inflammation and disruption of the nonvalvular endocardial surface of the cardiac chambers. We present a rare case of mural endocarditis on the intraventricular (IV) septum on both the left and right ventricular side with intact valvular annulus. This case highlights the complexity of the operative and postoperative management in an unprecedented case of biventricular mural endocarditis.</p>


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