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Left ventricular function after severe trauma

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To evaluate cardiac function at the early phase of severe trauma.


Prospective, clinical study.


Anesthesiological Intensive Care Unit.


7 consecutive patients admitted after severe trauma (ISS: 38±9, mean±SD), without preexisting cardiac disease.


Each patient received midazolam and sufentanyl for sedation. Right heart catheterization (Swan-Ganz) and transesophageal echocardiography (TEE) were performed. The fractional area change (FAC) of the left ventricle was calculated within 6 h following trauma and at day 1 and day 2 in order to evaluate left ventricular function.

Measurements and results

All of the patients had a low FAC value <50% at day 0 (43.2±2.4%, range 39–46%), which increased significantly at day 2 (52.5±4%, range 47–59%,p=0.001), whereas heart rate and preload (assessed by left ventricular end diastolic area and pulmonary arterial occlusion pressure) were constant and afterload, assessed by systolic blood pressure, increased significantly between day 0 and day 2 (112±21 to 145±24 mmHg,p=0.02).


The initial phase of severe trauma is associated with an abnormal cardiac function, suggested by a low FAC value. This myocardial dysfunction must be taken into account for early resuscitation after severe injury.

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  1. Moore FA, Haenel JB, Moore EE, Witehill TA (1992) Incommensurate oxygen consumption in response to maximal oxygen availability predicts postinjury multiple organ failure. J Trauma 33: 58–67

    Google Scholar 

  2. Horton JW (1989) Hemorrhagic shock depresses myocardial contractile function in the guinea pig. Circ Shock 28: 23–36

    Google Scholar 

  3. Kuwagata Y, Sugimoto H, Yoshioka T, Sugimoto T (1992) Left ventricular performance in patient with thermal injury or multiple trauma: a clinical study with echocardiography. J Trauma 32: 158–165

    Google Scholar 

  4. Cahalan MK, Pompilliu I, Melton HE Jr, Alder S, Kee LL, Schiller NB (1993) Automated real-time analysis of intraoperative transesophageal echocardiograms. Anesthesiology 78: 477–485

    Google Scholar 

  5. Clements FM, Harpole DH, Quill T et al. (1990) Estimation of left ventricular volume and ejection fraction by two-dimensional transo esophageal echocardiography: comparison of short axis imaging and simultaneous radionuclide angiography. Br J Anaesth 64: 331–336

    Google Scholar 

  6. Wyatt HL, Haendchen RV, Meerbaum S, Corday E (1983) Assessment of quantitative methods for 2-dimensionnal echocardiography. Am J Cardiol 52: 396–401

    Google Scholar 

  7. Drexler M, Erbel R, Muller U (1990) Measurements of intracardiac dimensions and structures in normal young adult subjects by transesophageal echocardiography. Am J Cardiol 65: 1491–1496

    Google Scholar 

  8. Robotham JL, Takata M, Berman M, Harasawa Y (1991) Ejection fraction revisited. Anesthesiology 74: 172–183

    Google Scholar 

  9. Steltzer H, Owen A, Petcold R, Germann P, Hammerle AF (1992) Small volume resuscitation: echo-cardiographically guided changes in left ventricular performance in patient with circulatory shock abstract. Anesthesiology 77: A229

    Google Scholar 

  10. Pfeiffer UJ, Perker M, Zeravik J, Zimmermann G (1987) Sensitivity of central venous pressure, pulmonary capillary wedge pressure, and intrathoracic blood volume as indicators for acute and chronic hypovolemia. In: Lewis FR, Pfeiffer UJ (eds) Practical applications of fiberoptics in critical care monitoring. Springer, Berlin Heidelberg New York, pp 25–30

    Google Scholar 

  11. Horton J, Landreneau R, Tuggle D (1985) Cardiac response to fluid resuscitation from hemorrhagic shock. Surg Gynecol Obstet 160: 444–452

    Google Scholar 

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Smaïl, N., Declère, A.D., Duranteau, J. et al. Left ventricular function after severe trauma. Intensive Care Med 22, 439–442 (1996).

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