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Abstract
Background. Prior functional studies on myocardial contusion (MC) have emphasized left ventricular
performance even though the right ventricle (RV) is more likely to be injured after
blunt trauma. Furthermore, associated injuries requiring resuscitation and surgery
are frequently present. Our aim was to evaluate the impact of MC on RV function after
MC and subsequent resuscitation from hemorrhagic shock.
Methods. RV performance was evaluated with a modified pulmonary artery catheter that determines
RV volumes and ejection fraction (RVEF), as well as filling pressures and cardiac
output in an anesthetized swine model.
Results. MC caused a 28% fall in mean arterial pressure and a 33% decrease in cardiac output.
RVEF was 82%, and RV stroke work was 49% of baseline after injury. Resuscitation of
hemorrhagic shock to baseline preload or greater failed to restore mean arterial pressure
or cardiac output (depressed 23% and 22%, respectively). RV end-diastolic volume returned
to baseline and central venous pressure was increased. RV dysfunction was depicted
by a sustained depression of RV stroke work and RVEF.
Conclusions. Impaired RV compliance and contractility, which was evident throughout this study,
may hamper resuscitative efforts after multiple blunt trauma. RV monitoring may be
useful in this setting.
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Article info
Footnotes
☆Presented at the Fiftieth Annual Meeting of the Central Surgical Association, Cincinnati, Ohio, March 4–6, 1993.
Identification
Copyright
© 1993 Published by Elsevier Inc.
