Right ventricular volumes overestimate left ventricular preload in critically ill patients

Eric J. Kraut, John T Owings, John T Anderson, Leland Hanowell, Peter G Moore

Research output: Contribution to journalArticle

15 Scopus citations

Abstract

Background: Studies have shown right ventricular end-diastolic volume (RVEDV) to be a more accurate estimate of left ventricular preload than pulmonary artery wedge pressure. We prospectively evaluated the ability of RVEDV to predict left ventricular end-diastolic volume (LVEDV) in critically ill patients. Methods: Thirty critically ill patients in the surgical intensive care unit underwent concurrent measurement of RVEDV and LVEDV. RVEDV was measured using a residual fraction Swan-Ganz catheter (RF Swan). LVEDV was measured using transesophageal echocardiography with acoustic quantification. Intracardiac, intra-abdominal, and ventilatory, pressures were also measured. Results: RVEDV as measured by the RF Swan was significantly larger (by a factor of 2) than LVEDV (p < 0.0001 analysis of variance). However, the RVEDV and LVEDV were strongly correlated (r = 0.71, p < 0.0001, Pearson's correlation). Conclusions: RVEDV from the RF Swan markedly overestimated left ventricular preload. If RVEDV is used as an absolute value for determining preload, patients may be underresuscitated. Transesophageal echocardiography in conjunction with RF Swan can be used to more accurately determine preload and cardiac performance than RF Swan alone in critically ill patients.

Original languageEnglish (US)
Pages (from-to)839-846
Number of pages8
JournalJournal of Trauma - Injury, Infection and Critical Care
Volume42
Issue number5
DOIs
StatePublished - May 1997

Keywords

  • Acoustic quantification
  • Left ventricular end-diastolic volume
  • Left ventricular function
  • Preload
  • Right ventricular end-diastolic volume
  • Right ventricular function
  • Transesophageal echocardiography

ASJC Scopus subject areas

  • Surgery

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