Abstract
Objective
To evaluate cardiac function at the early phase of severe trauma.
Design
Prospective, clinical study.
Setting
Anesthesiological Intensive Care Unit.
Patients
7 consecutive patients admitted after severe trauma (ISS: 38±9, mean±SD), without preexisting cardiac disease.
Interventions
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).
Conclusion
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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Smaïl, N., Declère, A.D., Duranteau, J. et al. Left ventricular function after severe trauma. Intensive Care Med 22, 439–442 (1996). https://doi.org/10.1007/BF01712161
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DOI: https://doi.org/10.1007/BF01712161