Fulltext

Volatile anaesthetics and positive pressure ventilation reduce left atrial performance: a transthoracic echocardiographic study in young healthy adults

Freiermuth, D. ; Skarvan, K. ; Filipovic, M. ; Seeberger, M. D. ; Bolliger, D. ; Absalom, A. R. ; Absalom, A. R.

In: British Journal of Anaesthesia, 2014, vol. 112, no. 6, p. 1032-1041

Ajouter à la liste personnelle
    Titre
    • Volatile anaesthetics and positive pressure ventilation reduce left atrial performance: a transthoracic echocardiographic study in young healthy adults
    Auteur
    • Freiermuth, D.. Department of Anaesthesia and Intensive Care Medicine, University Hospital Basel, CH-4031 Basel, Switzerland
    • Skarvan, K.. Department of Anaesthesia and Intensive Care Medicine, University Hospital Basel, CH-4031 Basel, Switzerland
    • Filipovic, M.. Institute for Anaesthesia, Cantonal Hospital St Gallen, CH-9007 St Gallen, Switzerland
    • Seeberger, M. D.. Department of Anaesthesia and Intensive Care Medicine, University Hospital Basel, CH-4031 Basel, Switzerland
    • Bolliger, D.. Department of Anaesthesia and Intensive Care Medicine, University Hospital Basel, CH-4031 Basel, Switzerland
    • Absalom, A. R.. University Hospital Basel, Department of Anaesthesia and Intensive Care Medicine, CH-4031 Basel, CH-9007 St Gallen, Switzerland, Switzerland
    • Absalom, A. R.. 1Department of Anaesthesia and Intensive Care Medicine, University Hospital Basel, CH-4031 Basel, Switzerland
    Type de document
    • Postprint
    Langue
    • Anglais
    Publié dans
    • British Journal of Anaesthesia, 2014, vol. 112, no. 6, p. 1032-1041. Oxford University Press
    Autre version électronique
    Identifiant OAI-PMH
    • oai:doc.rero.ch:303833
    Summary
    Background Animal and in vitro studies suggest that volatile anaesthetics affect left atrial (LA) performance. We hypothesized that human LA pump function and dimensions are altered by volatile anaesthetics in vivo. Methods We performed transthoracic echocardiographic (TTE) measurements in 59 healthy subjects (aged 18-48 yr) undergoing minor surgery under general anaesthesia. The unpremedicated patients were randomly assigned to anaesthesia with sevoflurane, desflurane, or isoflurane. TTE examinations were performed at baseline and after induction of anaesthesia and upon placement of a laryngeal mask during spontaneous breathing. After changing to intermittent positive pressure ventilation (IPPV), an additional TTE was performed. The study focused on the velocity-time integral of late peak transmitral inflow velocity (AVTI) and maximum LA volume. Results We found no evidence for relevant differences in the effects of the three volatile anaesthetics. AVTI decreased significantly from 4.1 (1.2) cm at baseline to 3.2 (1.1) cm during spontaneous breathing of 1 minimum alveolar concentration of volatile anaesthetics. AVTI decreased further to 2.8 (1.0) cm after changing to IPPV. The maximum LA volume was 45.4 (18.6) cm3 at baseline and remained unchanged during spontaneous breathing but decreased to 34.5 (16.7) cm3 during IPPV. Other parameters of LA pump function and dimensions decreased similarly. Conclusions Volatile anaesthetics reduced active LA pump function in humans in vivo. Addition of IPPV decreased LA dimensions and further reduced LA pump function. Effects in vivo were less pronounced than previously found in in vitro and animal studies. Further studies are warranted to evaluate the clinical implications of these findings. Clinical trial registration NCT0024451