Reference : Cyclic appearance of left ventricular outflow tract dynamic obstruction during mechanica...
Scientific journals : Article
Human health sciences : General & internal medicine
http://hdl.handle.net/2268/25021
Cyclic appearance of left ventricular outflow tract dynamic obstruction during mechanical ventilation: evidence for a preload dependent phenomenon.
English
Canivet, Jean-Luc mailto [Université de Liège - ULg > > Soins intensifs >]
Lancellotti, Patrizio mailto [Université de Liège - ULg > > Cardiologie >]
Radermecker, Marc mailto [Université de Liège - ULg > > Chirurgie cardio-vasculaire >]
Damas, Pierre mailto [Université de Liège - ULg > Département des sciences cliniques > Anesthésie et réanimation >]
Jul-2008
Journal of Intensive Care Medicine
SAGE Publications
23
4
281-4
Yes (verified by ORBi)
International
0885-0666
1525-1489
Thousand Oaks
CA
[en] The cyclic appearance of dynamic left ventricular outflow tract obstruction during mechanical ventilation, according to the phasic changes in preload, is described in this article. Hemodialysis-induced fluid removal resulted in preload dependence as evidenced by the pulse pressure variation in a 56-year-old critically ill patient. The clinical picture was suggestive of myocardial failure. Transthoracic echocardiography disclosed dynamic left ventricular outflow tract obstruction associated with systolic anterior motion of the mitral valve. Progressive fluid restitution resulted in a parallel decrease in both the degree of dynamic obstruction and pulse pressure variation. During fluid loading, dynamic obstruction disappeared at first during the inspiratory phase of intermittent positive pressure ventilation corresponding to the phasic increase in left ventricular preload. Further fluid loading resulted in the disappearance of dynamic obstruction during both inspiratory and expiratory phase of intermittent positive pressure ventilation. This is the first reported case clearly relating left ventricular outflow tract dynamic obstruction to preload dependence during mechanical ventilation in a critically ill patient without predisposing anatomical factor.
Professionals
http://hdl.handle.net/2268/25021
10.1177/0885066608318662
http://jic.sagepub.com/cgi/reprint/23/4/281

File(s) associated to this reference

Fulltext file(s):

FileCommentaryVersionSizeAccess
Open access
Canivet, J Intensive Care Med, 2008.pdfPublisher postprint696.4 kBView/Open

Bookmark and Share SFX Query

All documents in ORBi are protected by a user license.