UTILITY OF A BEDSIDE DOPPLER IN TRACKING LEFT-VENTRICULAR DYSFUNCTIONRELATED TO HEMORRHAGIC-SHOCK

Treatment of hemorrhagic shock with fluid resuscitation alone results in diastolic dysfunction as measured by peak systolic pressure/end sys tolic volume ratio (PSP/ESV). The purpose of this study was to test th e ability of a simple Doppler device to track diastolic dysfunction in hemorrhagic shock. In this prospective, controlled crossover study, f ive adult swine were resuscitated from hemorrhagic shock using fluids. Diastolic dysfunction was confirmed using PSP/ESV ratio. The effect o f nitroprusside and dobutamine on this diastolic dysfunction was evalu ated. Data (PSP/ESV, Doppler-derived acceleration, and oxygen transpor t parameters) were collected at each stage of the model. Arterial pres sure and oxygen transport parameters corrected to baseline values; how ever, the PSP/ESV and Doppler-derived acceleration failed to correct w ith fluid resuscitation alone. Treatment with nitroprusside and dobuta mine increased oxygen transport parameters, PSP/ESV ratio, and Doppler -derived acceleration significantly. Doppler-derived acceleration trac ks left ventricular dysfunction seen in hemorrhagic shock.