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Factors influencing the R-R interval during central venous injection in newborn swine

Abstract

Seven Yorkshire swine, ages 7–11 days and weighing 1.4–2.8 kg were studied to determine the effects of temperature and volume of injectate, depth of anaesthesia, position of the central venous catheter tip and vagotomy on the R-R interval after central venous injection of saline. The swine were anaesthetized with halothane in 100 per cent oxygen and their lungs ventilated to normocapnia. The length of the R-R varied inversely with the temperature of the injectate between 0 and 20° C reaching a maximum prolongation of 152 per cent above control values with 0° C saline. Injecting saline at 37° C did not affect the R-R interval. The length of the R-R interval varied directly with the volume of injectate between 1.5 and 4.5 ml· kg−1 (P < 0.05), The R-R interval response also varied directly with the depth of anaesthesia: the post-injection R-R interval increased from 185 per cent to 341 per cent as the end-tidal halothane concentration increased from 0.45 to 1.20 per cent. The position of the tip of the central venous catheter that produced the maximum increase in the R-R interval, as determined radiographically, was at the junction of the superior vena cava and the right atrium. Neither bilateral vagotomy nor atropine (50 μg · kg−1) affected the R-R interval after injecting 3 ml · kg−1 saline 0° C. We conclude that the increases in R-R interval after injection of fluid into the right atrium are due to direct effects on the nerve conduction system of the heart, possibly on the sinoatrial node.

Résumé

Afin de déterminer les effets de la température du volume injecté, la profondeur de l’anesthésie, la position du bout du catheter veineux central et de la vagotomie sur l’intervalle R-R aprés une injection intraveineuse par voie centrale, sept porcs Yorkshire, âgés de 7–11 jours et pesant de 1.4–2.8 kg ont été étudiés. Les pores ont été anesthésiés avec l’halothane et 100 pour cent d’oxygène et ventilés pour atteindre une normocapnie. La longueur de l’espace de l’intervalle R-R était inversement proportionnelle á la température du liquide injecté pour des temperatures variant de 0 et 20° C attteignant un maximum de prolongation de 152 per cent du contrôle à 0° C. Le salin injecté à 37° C n’a pas affecté l’intervalle R-R. La longueur de l’intervalle R-R variait directement avec le volume du salin injecté entre des valeurs de l.5 à 4.5 ml · kg−1 (P < 0.05). Cet intervalle R-R a aussi varié directement avec la profondeur de l’anesthésie: apris l’injection cet intervalle augmenta de 185 pour cent à 341 pour cent quand la concentration d’halothane en fin dexpiration augmenta de 0.45 à 1.20 pour cent. La position du bout du cathiter veineux central qui produisit le maximum d’augmentation de l’intervalle R-R, déterminée radiologiquement, était à la jonction de la veine cave supérieure et l’oreillette droite. Ni la vagotomie bilatérale ou l’atropine (50 μg · kg−1) n’ont affecté l’ intervalle R-R apris l’ injection de 3 ml · kg−1 à° C de salin. On conclut que les augmentations de l’ intervalle R-R aprés injection de liquide dans l’oreillette droite sont dues aux effets directs sur le systeme de conduction nerveux du cœur possiblement au niveau du noeud sinusal.

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Supported with a grant from the Heart and Stroke Foundation of Ontario

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Oyston, J.P., Burrows, F.A. & Lerman, J. Factors influencing the R-R interval during central venous injection in newborn swine. Can J Anaesth 36, 554–559 (1989). https://doi.org/10.1007/BF03005385

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  • DOI: https://doi.org/10.1007/BF03005385

Key words

  • Complications: arrhythmia
  • Heart: arrhythmia, pulse rate, thermodilution, sino-atrial node
  • Measurement Techniques: cardiac output, thermodilation, venous pressure
  • Paprasympathetic Nervous System: vagus
  • Temperature: cooling