Hemodynamic parameters determined by transesophageal doppler echocardiography and pulmonary artery catheter after volume administration in patients receiving off-pump coronary artery bypass surgery: a correlation analysis

Abstract

Objective:To investigate the changes of hemodynamic parameters by transesophageal doppler echocardiography(TEE) and pulmonary artery catheter(PCA) before and after volume administration in patients receiving off-pump coronary artery bypass(OPCAB) surgery,to analyze the correlation between the two methods,and to discuss the value of TEE in monitoring the preload during OPCAB.Methods: Twenty patients who were to receive OPCAB were enrolled in the present study.TEE was used to determine the mitral valve flow(MVF).Simultaneously,the central vein pressure(CVP),pulmonary capillary wedge pressure(PCWP),pulmonary artery pressure(PAP),mixed venous oxygen saturation(SvO2),cardiac output(CO),cardiac index(CI),and stroke volume(SV) were examined during OPCAB by PCA.The above parameters were recorded before and immediately after volume infusion(5 ml/kg,in 10 minutes).Patients with SV increased by 10% were taken as effective responders.Pearson correlation analysis was used to examine the relationship of SV with the results of TEE and PAC.Results: There were 14 effective responders after the first volume load,and only 6 after the second infusion.Compared with the baseline values,PCWP of all the patients,and CO,CI and SV of the effective responders increased significantly after volume loading(P0.05);the values of MVe,MTIe,and VTIe+a also increased significantly after volume loading(P0.05);and there were no significant changes in MVa,VTIa,MVedt values after volume loading.The results of correlation analysis of SV with other parameters were: MVe(r=0.36,P0.05),VTImve(r=0.63,P0.05),VTIe/VTIa(r=0.67,P0.01),VTIe+a(r=0.77,P0.01),and PCWP(r=0.35,P0.01).SvO2 was increased after infusion(P0.05).Conclusion: The relationship of TEE parameters with SV is variable.There is a significant positive correlation between SV with VTIe and VTIe+a;and VTI can be used to evaluate the preload of left ventricular,which should be further studied to guide clinical medication.