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Haemodynamic changes due to clamping of the abdominal aorta

Summary

Haemodynamic changes due to aortic cross-clamping were examined in 18 patients. It has been shown that the distal occlusion of the abdominal aorta induces an increased impedance to ejection. Because the mechanisms controlling the autoregulation of cardiac output and the circulatory reflexes are damped by anaesthesia, the augmentation of resistance is not followed by any increase in contractility or vasomotor tone and thus the cardiac output falls. Patients with chronic obstructive disease (Leriche) did not differ significantly from subjects with more acute obstruction ( aneurysm ), though the latter have a tendency to show more important changes in their haemodynamic response.

Résumé

Nous avons étudié les changements hémodynamiques causés par ľocclusion de ľaorte abdominale chez 18 patients qui ne présentaient aucune évidence clinique de maladie cardiaque. Ľétude a révélé que ľocclusion basse de ľaorte abdominale provoque une augmentation de ľimpédance à ľéjection. Comme ľanesthésie amène une dépression des mécanismes ďautorégulation du débit cardiaque et des réflexes circulatoires, il n’y a pas ďamélioration de la contractilité myocardiaque ni du tonus vasomoteur, ďoù baisse du débit cardiague. Les malades présentant une maladie obstructive progressive ( Leriche ) ne diffèrent pas de façon significative de ceux qui ont une obstruction subite (anévrysme); quoique ces derniers présentent des changements plus marqués. Une attention toute spéciale doit être portée à la stabilité de ľanesthésie afin ďéviter les crises hypertensives et de tachycardie, et de conserver une certaine activité sympathique.

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Correspondence to R. Meloche or T. Pottecher or J. Audet or O. Dufresne or C. Lepage.

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Meloche, R., Pottecher, T., Audet, J. et al. Haemodynamic changes due to clamping of the abdominal aorta. Canad. Anaesth. Soc. J. 24, 20–34 (1977). https://doi.org/10.1007/BF03006809

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Keywords

  • Cardiac Output
  • Stroke Volume
  • Cardiac Index
  • Systemic Vascular Resistance
  • CANADIAN Anaesthetist