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The effect of aorta unfolding and remodelling on oesophageal Doppler readings as probe depth is varied
Zhang, J.1; Critchley, L. A. H.2; Huang, L.3
关键词aortic unfolding oesophageal Doppler stroke volume
刊名BRITISH JOURNAL OF ANAESTHESIA
2015-11-01
DOI10.1093/bja/aev343
115期:5页:708-715
收录类别SCI
文章类型Article
WOS标题词Science & Technology
类目[WOS]Anesthesiology
研究领域[WOS]Anesthesiology
关键词[WOS]CARDIAC COMPUTED-TOMOGRAPHY ; HOSPITAL STAY ; ASCENDING AORTA ; MAJOR SURGERY ; BODY-SIZE ; GENDER ; AGE ; ADULTS ; MONITOR ; IMPACT
英文摘要

Background: The thoracic aorta elongates and unfolds with advancing age. Lateral displacement and tortuosity of the descending part may affect oesophageal Doppler monitoring (ODM) readings because probe alignment becomes slanted. This investigation aimed to relate aortic displacement as it appears on the chest radiograph with variations in ODM readings as the probe is inserted to different depths.

Methods: In anaesthetized patients a series of three to five ODM stroke volume (SV) readings were obtained at insertion depths of 35-45 cm during stable haemodynamics. The coefficient of variation (CV=standard deviation/mean %) was calculated. The degree of descending aorta unfolding was measured by (i) lateral displacement (LD), that is, the difference in the maximum and minimum distances between the midline and para-aortic line; and (ii) curvature angle (CA), the angle formed by a tangential line from the intersection of the para-aortic line and the diaphragm to its curve with the vertical line.

Results: Data from 70 patients were analysed. The median CV of SV readings was 14% (range 4-48). Variation between ODM readings, shown by the CV of SV readings, increased linearly with aortic unfolding: R-2=0.44 for LD and R-2=0.60 for CA. Patients with a CA <= 15 degrees were younger and had significantly lower CVs of ODM readings than those with a CA >15 degrees (P=0.001). Age and hypertension was associated with increased CA.

Conclusions: Increased lateral displacement and tortuosity of the descending aorta reduces the reliability of ODM measurements as probe depth is varied, especially with aging.

语种英语
WOS记录号WOS:000363934700010
引用统计
文献类型期刊论文
条目标识符http://ir.bjmu.edu.cn/handle/400002259/66957
专题北京大学第一临床医学院
北京大学第二临床医学院_药剂科
作者单位1.Zhengzhou Univ, Affiliated Hosp 1, Dept Anesthesiol, Zhengzhou 450052, Peoples R China
2.Chinese Univ Hong Kong, Prince Wales Hosp, Dept Anaesthesia & Intens Care, Shatin, Hong Kong, Peoples R China
3.Peking Univ, Hosp 1, Dept Anesthesia & Surg Intens Care, Beijing 100871, Peoples R China
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Zhang, J.,Critchley, L. A. H.,Huang, L.. The effect of aorta unfolding and remodelling on oesophageal Doppler readings as probe depth is varied[J]. BRITISH JOURNAL OF ANAESTHESIA,2015,115(5):708-715.
APA Zhang, J.,Critchley, L. A. H.,&Huang, L..(2015).The effect of aorta unfolding and remodelling on oesophageal Doppler readings as probe depth is varied.BRITISH JOURNAL OF ANAESTHESIA,115(5),708-715.
MLA Zhang, J.,et al."The effect of aorta unfolding and remodelling on oesophageal Doppler readings as probe depth is varied".BRITISH JOURNAL OF ANAESTHESIA 115.5(2015):708-715.
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