Comparison Research Of The Variations Of Volume Load In Dogs By Volumetric Pulmonary Artery Catheter And Transesophageal Echocardiography

Detecting the ventricular preload by volumetric pulmonary artery catheter or transesophageal echocardiography emerged only recently,which lead us from the stage of pressure estimate to volumetric detection.Our study aimed to reveal the difference and relativity between two methods.[Objective]To observe the practice of detecting the ventricular preload by volumetric pulmonary artery catheter and transesophageal echocardiography.To investigate relativity and difference between of the two methods.[Methods]8 dogs weighting 12 to 22Kg were given general anesthesia.An arterial line was put into the femoral artery and a volumetric pulmonary artery catheter was put into jugular vein.Then the probe of transesophageal echocardiography was placed in the middle of the esophagus to show left two-charmber view.The stable status was confirmed within 5 minutes heart beats and mean arterial pressure changed no more than±5beats/min and±2.5mmHg.6%Hetastarch Injection 3mL/Kg as volume load was infused over 10 minutes.Data was collected at basic time point of(0min),3min,5min,7min and 10min point,including right ventricular end-diastolic volume(RVEDV),cardio output(CO),heart beats(HR),right ventricular stroke volume(RVSV),pulmonary artery wedge pressure(PAWA),right ventricular ejection fraction(RVEF),mean arterial pressure(MAP),left ventricular end-diastolic area(LVEDA),left ventricular ejection fraction area(LVEFa), variation of right ventricular end-diastolic volume(ΔRVEDV),variation of cardio output(ΔCO),variation of heart beats(ΔHR),variation of right ventricular stroke volume(ΔRVSV),variation of pulmonary artery wedge pressure(ΔPAWA), variation of right ventricular ejection fraction(ΔRVEF),variation of mean arterial pressure(ΔMAP),variation of left ventricular end-diastolic area(ΔLVEDA), variation of left ventricular ejection fraction area(ΔLVEFa).[Results]There were no significant changes in PAWP,RVEDV and LVEDA between time point groups(P＞0.05),which imply that the absolute values of these index didn't show any increase after infusion.The positive correlation(r=0.384,P=0.000) between RVEDV and LVEDA suggest that the two ways of detect status of preload is consistent.There were significant difference inΔRVEDV andΔLVEDA between time point groups(P＜0.05),which means that the corresponding variation values of these indexes were significant changed along with the increase of volume load at the time points.A positive correlation was observed betweenΔRVEDV andΔLVEDA(r=0.0329,P=0.000),which indicate the consistent correlation between two methods.There was no significant difference inΔPAWP between time point groups(P＞0.05),which indicate that the classic index of ventricular preload didn't change along with the increase of volume load.Also there were no significant correlations betweenΔPAWP andΔRVEDV orΔLVEDA.That means that the change of the index of PAWP isn't correlative with the change of preload.There were significant positive correlations between PAWP and RVEDV or LVEDA.It shows that the index of PAWP has the relationship of consistent correlation with the two new ways of detecting preload status of value.[Conclusion]The two methods of volumetric pulmonary artery catheter and transesophageal echocardiography can detect the status and changes of volume load, and show significant positive correlations with each other in detecting the status and changes of the preload.Pulmonary artery wedge pressure,which indicate the preload status of whole object level and no changes of the preload,shows limit signification as the index of preload.