E0029476

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Not Applicable (or Unknown)

カイシンジュツチュウ トクニ マスイ ドウニュウジ ノ ケッコウ ドウタイ ニカンスル リンショウテキ ケンキュウ

Significance of teh hemodynamic changes after induction of anesthesia in cases of open heart surgery

Japanese (日本語)

Medical journal of Kobe University

46(1)

37-54

1984-09

Seventy-three patients with acquired heart diseases undergoing open-heart surgery, including 37 patients with mitral valvular diseases, 21 with aortic valvular diseases and 15 with coronary artery diseases, were studied to evaluate the significance of the hemodynamic changes after induction of anesthesia. These patients were anesthetized with fentanyl or morphine. Hemodynamic data were obtained six times at the operating room and six times in the early postoperative period at the intensive care unit (ICU). Measurements of hemodynamic data included cardiac index (CI), mean blood pressure (BPm), mean pulmonary arterial pressur (PAm), mean pulmonary capillary pressure (PCm), mean right atrial pressure (RAm), total systemic vascular resistance (TSR) and total pulmonary arterial resistance (PAR). Data were analyzed for statistical significance by Student's t-test. Following results and conclusion were obtained ; Cardiac index decreased approximately 1l/min/m^2 after induction of anesthesia. It began to decrease after start of induction of anesthesia and reached a peak of 2.19l/min/m^2 in average in the period of just before skin incision. Decrease in cardiac index and blood pressure after induction of anesthesia was especially remarkable in the patients of coronary artery disease. Postoperative course of those patients who showed a decrease in cardiac index below 1.50l/min/m^2 after induction of anesthesia, were complicated more frequently by low output syndrome with prolonged stay at ICU. Change in cardiac output after induction of anesthesia was considered to be an useful index to predict postoperative course.

hemodynamic change

紀要論文