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Abdominal surgery (von Französisch in Englisch)

Optimal Volume Loading and Intravenous Nitroglycerin in Abdominal Aortic Surgery

Abstract:

Haemodynamic investigations were conducted in 9 patients during aortic surgery for Leriche's syndrome. Most of these patients had ischaemic heart disease without cardiac failure. Fluid loading was carried out before and during aortic clamping. It was controlled according to the optimal pulmonary wedge pressure determined the day before surgery. Only six of the nine patients received nitroglycerin (NTG: 0.2 mg/kg/min) throughout the operation. Before clamping, the cardiac index improved in patients treated with NTG. During clamping, the patients not treated with NTG showed a drop in their cardiac index, an increase in peripheral resistance and in left ventricular work. After declamping, there were no haemodynamic differences between the two groups. Two patients not treated with NTG developed renal failure post-operatively; one patient developed cardiac failure requiring a dopamine infusion during surgery. In this series, the association of optimal volume loading with a per-operative infusion of 0.2 mg/kg/min of NTG gave good haemodynamic stability.