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Effets de la posture sur la réponse au remplissage vasculaire by Collectif

Effets de la posture sur la réponse au remplissage vasculaire

by Collectif
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Book cover type: Paperback
  • ISBN13: 9783838148021
  • Binding: Paperback
  • Subject: N/A
  • Publisher: Academiques
  • Publisher Imprint: Academiques
  • Publication Date:
  • Pages: 52
  • Original Price: GBP 36.0
  • Language: French
  • Edition: N/A
  • Item Weight: 91 grams
  • BISAC Subject(s): General

La chirurgie en d�cubitus ventral (DV) s'accompagne de modifications h�modynamiques. L'objectif de ce travail a �t� de tester l'impact du DV sur la r�ponse h�modynamique au remplissage vasculaire (RV) et sur la variation respiratoire du volume d'�jection systolique (VVE). 53 patients ont �t� inclus dans cette �tude prospective (2 groupes: ventral et dorsal), pour une chirurgie du rachis ou une chirurgie intracr�nienne. Les donn�es ont �t� recueillies par un moniteur VigileoTM avant l'incision chirurgicale, � T0 puis toutes les 5 minutes pendant 30 minutes. Le RV a �t� r�alis� par 500 ml de Voluven(R). Une r�ponse positive au RV a �t� d�finie par une augmentation de l'index cardiaque (IC) 15 % sur 30 minutes. L'IC mesur� � T0 �tait plus faible dans le groupe DV par rapport au groupe d�cubitus dorsal (DD). A T30, le RV a induit la m�me augmentation de l'IC dans les 2 groupes. Enfin, la VVE n'�tait pas significativement diff�rente et ne peut pas �tre retenue comme un indice pr�dictif fiable de la r�ponse � l'expansion vol�mique. La g�ne au retour veineux lors de la mise en DV retentit sur le remplissage du myocarde. Un RV avant la mise en DV de ces patients est alors justifi�.

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