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Cardiovascular Monitoring During Elective Aortic Surgery
Gary G. Nicholas, MD;
Donald E. Martin, MD;
Mary D. Osbakken, PhD, MD
Arch Surg. 1983;118(11):1256-1258.
Abstract
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• We designed a prospective study to determine whether cardiac ejection fraction as measured noninvasively could isolate a subset undergoing aortic surgery for whom central venous pressure (CVP) predicted pulmonary artery wedge pressure (PAWP). Sixteen patients were studied. Simultaneous values of PAWP and CVP were analyzed, using linear regression analysis. A significant correlation between CVP and PAWP was found for the entire patient population and for each of four time periods: preoperative, before and after aortic cross-clamping, during aortic cross-clamping, and postoperative. A significant correlation between PAWP and CVP was found during the entire perioperative period for 14 of the 16 patients. However, the slope of the regression line, or the sensitivity of the CVP in reflecting changes in PAWP, was greater than 0.5 in only seven of the 16 patients. There was no correlation between the preoperative ejection fraction and the CVP/PAWP. We conclude that the CVP is an insensitive indicator of left ventricular filling pressure in most patients accepted for elective infrarenal aortic surgery, and monitoring of the PAWP is recommended.
(Arch Surg 1983;118:1256-1258)
Author Affiliations
From the Departments of Surgery (Dr Nicholas), Anesthesia (Dr Martin), and Medicine (Dr Osbakken), The Milton S. Hershey Medical Center, The Pennsylvania State University, Hershey.
Footnotes
Accepted for publication March 28, 1983.
Read in part before the annual meeting of the American Society of Anesthesiologists, Las Vegas, Oct 25, 1982.
Reprint requests to Department of Surgery, Lehigh Valley Hospital Center, Allentown, PA 18103 (Dr Nicholas).
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