Article

2 Iconography
Access to the text (HTML) Access to the text (HTML)
PDF Access to the PDF text
Advertising


Access to the full text of this article requires a subscription.
  • If you are a subscriber, please sign in 'My Account' at the top right of the screen.

  • If you want to subscribe to this journal, see our rates



@@#116300@@

Anaesthesia Critical Care & Pain Medicine
Sous presse. Epreuves corrigées par l'auteur. Disponible en ligne depuis le vendredi 11 janvier 2019
Doi : 10.1016/j.accpm.2018.12.006
Etomidate-induced hypotension: a pathophysiological approach using arterial elastance
 

Osama Abou Arab 1, 2, , Marc Olivier Fischer 3, Alexis Carpentier 4, Christophe Beyls 5, Pierre Huette 6, Abdel Hchikat 7, Amar Benammar 8, Beatris Labont 9, Yazine Mahjoub 10, 11, Stéphane Bar 12, 11, Pierre-Grégoire Guinot 13, Emmanuel Lorne 14, 11
1 Medical doctor, Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, 80054, France 
2 MP3CV, EA7517, CURS, Jules Verne University of Picardie, 80054 Amiens, France 
3 Medical doctor, Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, 80054, France 
4 Medical doctor, Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, 80054, France 
5 Medical doctor, Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, 80054, France 
6 Medical doctor, Department of Anaesthesiology and Critical Care Medicine, CHU de Caen, Anaesthesiology. Caen University Hospital. Caen, 14000, France 
7 Medical doctor, Department of Anaesthesiology and Critical Care Medicine, CHU de Caen, Anaesthesiology. Caen University Hospital. Caen, 14000, France 
8 Medical doctor, Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, 80054, France 
9 Medical doctor, Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, 80054, France 
10 Professor, Department of Anaesthesiology and Critical Care Medicine, Dijon University Hospital, Dijon, 14033 France 
11 SSPC (Simplification des Soins des Patients Complexes) - Clinical Research Unit, University of Picardie Jules Verne, 80054 Amiens Cedex 01, France 
12 Medical doctor, Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, 80054, France 
13 Professor, Department of Anaesthesiology and Critical Care Medicine, Dijon University Hospital, Dijon, 14033 France 
14 Professor, Department of Anaesthesiology and Critical Care Medicine, Amiens Picardy University Hospital, Amiens, 80054, France 

Correspondence to: Department of Anaesthesiology and Critical Care Medicine, Amiens University Hospital, Place Victor Pauchet, Amiens, 80054, FranceDepartment of Anaesthesiology and Critical Care MedicineAmiens University HospitalPlace Victor PauchetAmiens80054France
Abstract

Introduction: Anaesthesia frequently induces hypotension. Several recent studies have analysed arterial elastance (Ea) in order to describe clinical variations of mean arterial pressure (MAP). The objective of the study was to assess Ea to explain MAP variation following etomidate induction.

Methods: We conducted a prospective single-centre study. Inclusion criteria were patients undergoing elective cardiac surgery with invasive blood pressure monitoring. Ea was expressed as Pes/SV (Pes: end systolic pressure, SV: stroke volume). Cardiac index (CI), peripheral vascular resistance (PVR) and arterial compliance (C) was compared before and 2 minutes after etomidate induction. Arterial hypotension was defined as a decrease greater than 15% of the baseline MAP.

Results: Of the 45 patients included, 24 (53%) had a preserved MAP and 21 (47%) had an etomidate-induced hypotension. Ea was similar before induction and decreased in the decreased MAP group 2 minutes after induction (2.0 mmHg.ml-1 [1.7-2.4] vs 1.4 mmHg.ml-1 [0.9-1.9]; p = 0.001). Arterial compliance (C) increased in the decreased MAP group 2 minutes after induction (0.8 ml. mmHg-1 [0.6-1.0] vs 0.5 ml. mmHg-1 [0.4-0.6], p < 0.0001). No significant change in CI or PVR was observed between patients with or without etomidate-induced hypotension.

Conclusion: Etomidate-induced hypotension was associated to a decrease in Ea. Ea variations can mainly be explained by induced changes in arterial compliance.

The full text of this article is available in PDF format.

Keywords : arterial elastance, anaesthesia, Windkessel, arterial hypotension




© 2018  Société française d'anesthésie et de réanimation (Sfar)@@#104156@@
EM-CONSULTE.COM is registrered at the CNIL, déclaration n° 1286925.
As per the Law relating to information storage and personal integrity, you have the right to oppose (art 26 of that law), access (art 34 of that law) and rectify (art 36 of that law) your personal data. You may thus request that your data, should it be inaccurate, incomplete, unclear, outdated, not be used or stored, be corrected, clarified, updated or deleted.
Personal information regarding our website's visitors, including their identity, is confidential.
The owners of this website hereby guarantee to respect the legal confidentiality conditions, applicable in France, and not to disclose this data to third parties.
Close
Article Outline