Reference : Measurement of endocardial viability ratio (E.V.R.) during anesthesia for cardiac surgery
Scientific journals : Article
Human health sciences : Anesthesia & intensive care
Measurement of endocardial viability ratio (E.V.R.) during anesthesia for cardiac surgery
Larbuisson, Robert mailto [Centre Hospitalier Universitaire de Liège - CHU > > Anesthésie et réanimation >]
Brunain, J. P. [> >]
Lamy, Maurice mailto [Université de Liège - ULg > Département des sciences cliniques > Département des sciences cliniques >]
Acta Anaesthesiologica Belgica
Acta Medica Belgica
Yes (verified by ORBi)
[en] Anesthesia, General ; Blood Pressure ; Cardiac Output ; Cardiac Surgical Procedures ; Endocardium/physiology ; Extracorporeal Circulation ; Female ; Heart Function Tests/methods ; Humans ; Male ; Middle Aged ; Monitoring, Physiologic ; Myocardium/metabolism ; Oxygen Consumption
[en] Since sub-endocardial ischemia is the consequence of a discrepancy between the blood demand and supply of oxygen at this level, the study of the myocardial performance by the measurement of the endocardial viability ratio (E.V.R.) is both useful and possible during anesthesia. E.V.R. is the ratio between the oxygen supply and demand of the myocardium. It is equal to the diastolic pressure time index (D.P.T.I.) over the tension time index (T.T.I.). Measurements are made at different times, by means of the arterial pressure and the left atrial pressure, as well as with the Datascope-E.V.R. Computer. During gradual morphine administration (0.5-1-1.5 mg/kg) and if no major surgical stress occurs, E.V.R. remains excellent and stable (1.46 - 1.48 - 1.43). It deteriorates more or less (1.29 - 1.09) during tachycardia or hypertension. Within the hour following the end of extracorporeal circulation, E.V.R. significantly improves (1.04 - 1.06 - 1.09 - 1.23). Although E.V.R. measurement is easy during cardiac surgery, it is impossible to carry out in case of arrhythmia. While morphine anesthesia induces no variation in E.V.R., tachycardia or hypertension require the addition of therapeutic drug. Within one hour following the end of extra-corporeal circulation, E.V.R. measurement shows improved endocardial viability, although the hemodynamic parameters undergo no significant change.

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