Vectorcardiographic changes during laparoscopiccholecystectomy may mimic signs of myocardial ischaemia

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Vectorcardiographic changes during laparoscopiccholecystectomy may mimic signs of myocardial ischaemia

Gannerdahl, Per E. (författare): Dept. Anaesthiol. and Intensive Care, Karolinska Institute and Hospital, Stockholm, Sweden

Odeberg, S. (författare): Karolinska Institutet

Ljungqvist, Olle, 1954- (författare): Karolinska Institutet,Örebro universitet,Institutionen för medicinska vetenskaper,Department of Surgery, Karolinska Institute and Hospital, Stockholm, Sweden

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Sollevi, Alf (författare): Karolinska Institutet

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Karolinska Institutet Dept Anaesthiol. and Intensive Care, Karolinska Institute and Hospital, Stockholm, Sweden (creator_code:org_t)

Elsevier, 1997
1997
Engelska.
Ingår i: Acta Anaesthesiologica Scandinavica. - : Elsevier. - 0001-5172 .- 1399-6576. ; 41:9, s. 1187-1192

Relaterad länk:: https://urn.kb.se/re...; visa fler...; https://doi.org/10.1...; http://kipublication...; visa färre...

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Abstract Ämnesord

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Laparoscopic surgery involves the use of intra-abdominal carbon dioxide insufflation (pneumoperitoneum). The increased intra-abdominal pressure causes marked haemodynamic changes, which may influence electrocardiographic monitoring. The aim of the present study was to elucidate the influence of pneumoperitoneum on vectorcardiographic recordings.METHODS:Vectorcardiographic changes (QRS vector difference = QRS-VD, QRS loop area, QRS magnitude, ST vector magnitude, spatial ST vector change) were recorded continuously applying computerized vectorcardiography in 12 anaesthetised cardiovascularly healthy patients, scheduled for laparoscopic cholecystectomy. Measurements were made before and during pneumoperitoneum in three different body positions (supine, Trendelenburg and reversed Trendelenburg), also employing transesophageal echocardiography and invasive blood pressure monitoring.RESULTS:Pneumoperitoneum significantly increased QRS-VD, in parallel with an enlargement in loop area and magnitude. The magnitude was significantly increased in the transversal and frontal planes and there was a tendency to increase the magnitude in the sagittal plane. The increase in QRS-VD reached levels previously associated with the development of myocardial ischaemia in patients with coronary artery disease. The ST-variables were not changed by the pneumoperitoneum. The positional changes also influenced QRS-VD significantly.CONCLUSIONS:When computerized vectorcardiography is used for ischaemia monitoring during pneumoperitoneum, the ST-variables seem reliable. However, vectorcardiographicQRS-changes should be interpreted with caution, as the QRS alterations found during pneumoperitoneum mimic the changes seen during myocardial ischaemia.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Anestesi och intensivvård (hsv//swe)
MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Anesthesiology and Intensive Care (hsv//eng)

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Av författaren/redakt...: Gannerdahl, Per ...; Odeberg, S.; Ljungqvist, Olle ...; Sollevi, Alf

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MEDICIN OCH HÄLSOVETENSKAP: MEDICIN OCH HÄLS ...; och Klinisk medicin; och Anestesi och int ...

Artiklar i publikationen: Acta Anaesthesio ...

Av lärosätet: Örebro universitet; Karolinska Institutet

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