Transesophageal echocardiography as a useful tool in evaluating right ventricular function during inhaled nitric oxide therapy

Sangeeta Bhorade*, K. Spencer, R. Lang, M. O'Connor, A. Pohlman, J. Hall

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

Abstract

Purpose: In patients with right ventricular failure (RVF), inhaled nitric oxide (NO), a selective pulmonary vasodilator, has been beneficial in reducing pulmonary artery pressures and improving cardiac output. Interpreting invasive pressure monitoring in the absence of ventricular volume data in this setting is confounded by ventricular interaction and myocardial compliance changes. Thus, we employed echocardiography to assess the effects of NO in RVF. Methods: We used continuous transesophageal echocardiography monitoring to evaluate the benefit of inhaled NO therapy in five patients with RVF. Results: In all five patients, fractional shortening area of the right ventricle (End diastolic area - End systolic area)/(End diastolic area) was calculated on and off NO therapy. The mean fractional shortening area was 17.7%±8.14 on NO and 21.2%±6.38 off NO. In addition, figure 1 plots the graph of fractional area change (FAC) in one patient as the inhaled NO was titrated. (Graph Presented). Conclusion: Echocardiography is a safe and simple technique to monitor right v entricular function during treatment of RVF. The use of the TEE probe allows one to monitor patients for longer periods of time as therapy is titrated over time. Clinical Implication: We advocate the use of echocardiography in evaluation of right ventricular function in critically ill patients.

Original languageEnglish (US)
JournalChest
Volume110
Issue number4 SUPPL.
StatePublished - Oct 1 1996

ASJC Scopus subject areas

  • Pulmonary and Respiratory Medicine
  • Critical Care and Intensive Care Medicine
  • Cardiology and Cardiovascular Medicine

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