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Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients

Purpose. The effects of mechanical ventilation (MV) on speckle tracking echocardiography- (STE-)derived variables are not elucidated. The aim of the study was to evaluate the effects of positive end-expiratory pressure (PEEP) ventilation on 4-chamber longitudinal strain (LS) analysis by STE. Methods...

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Autores principales: Franchi, Federico, Faltoni, Agnese, Cameli, Matteo, Muzzi, Luigi, Lisi, Matteo, Cubattoli, Lucia, Cecchini, Sofia, Mondillo, Sergio, Biagioli, Bonizella, Taccone, Fabio Silvio, Scolletta, Sabino
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Hindawi Publishing Corporation 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771268/
https://www.ncbi.nlm.nih.gov/pubmed/24066303
http://dx.doi.org/10.1155/2013/918548
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author Franchi, Federico
Faltoni, Agnese
Cameli, Matteo
Muzzi, Luigi
Lisi, Matteo
Cubattoli, Lucia
Cecchini, Sofia
Mondillo, Sergio
Biagioli, Bonizella
Taccone, Fabio Silvio
Scolletta, Sabino
author_facet Franchi, Federico
Faltoni, Agnese
Cameli, Matteo
Muzzi, Luigi
Lisi, Matteo
Cubattoli, Lucia
Cecchini, Sofia
Mondillo, Sergio
Biagioli, Bonizella
Taccone, Fabio Silvio
Scolletta, Sabino
author_sort Franchi, Federico
collection PubMed
description Purpose. The effects of mechanical ventilation (MV) on speckle tracking echocardiography- (STE-)derived variables are not elucidated. The aim of the study was to evaluate the effects of positive end-expiratory pressure (PEEP) ventilation on 4-chamber longitudinal strain (LS) analysis by STE. Methods. We studied 20 patients admitted to a mixed intensive care unit who required intubation for MV and PEEP titration due to hypoxia. STE was performed at three times: (T1) PEEP = 5 cmH(2)O; (T2) PEEP = 10 cmH(2)O; and (T3) PEEP = 15 cmH(2)O. STE analysis was performed offline using a dedicated software (XStrain MyLab 70 Xvision, Esaote). Results. Left peak atrial-longitudinal strain (LS) was significantly reduced from T1 to T2 and from T2 to T3 (P < 0.05). Right peak atrial-LS and right ventricular-LS showed a significant reduction only at T3 (P < 0.05). Left ventricular-LS did not change significantly during titration of PEEP. Cardiac chambers' volumes showed a significant reduction at higher levels of PEEP (P < 0.05). Conclusions. We demonstrated for the first time that incremental PEEP affects myocardial strain values obtained with STE in intubated critically ill patients. Whenever performing STE in mechanically ventilated patients, care must be taken when PEEP is higher than 10 cmH(2)O to avoid misinterpreting data and making erroneous decisions.
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spelling pubmed-37712682013-09-24 Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients Franchi, Federico Faltoni, Agnese Cameli, Matteo Muzzi, Luigi Lisi, Matteo Cubattoli, Lucia Cecchini, Sofia Mondillo, Sergio Biagioli, Bonizella Taccone, Fabio Silvio Scolletta, Sabino Biomed Res Int Clinical Study Purpose. The effects of mechanical ventilation (MV) on speckle tracking echocardiography- (STE-)derived variables are not elucidated. The aim of the study was to evaluate the effects of positive end-expiratory pressure (PEEP) ventilation on 4-chamber longitudinal strain (LS) analysis by STE. Methods. We studied 20 patients admitted to a mixed intensive care unit who required intubation for MV and PEEP titration due to hypoxia. STE was performed at three times: (T1) PEEP = 5 cmH(2)O; (T2) PEEP = 10 cmH(2)O; and (T3) PEEP = 15 cmH(2)O. STE analysis was performed offline using a dedicated software (XStrain MyLab 70 Xvision, Esaote). Results. Left peak atrial-longitudinal strain (LS) was significantly reduced from T1 to T2 and from T2 to T3 (P < 0.05). Right peak atrial-LS and right ventricular-LS showed a significant reduction only at T3 (P < 0.05). Left ventricular-LS did not change significantly during titration of PEEP. Cardiac chambers' volumes showed a significant reduction at higher levels of PEEP (P < 0.05). Conclusions. We demonstrated for the first time that incremental PEEP affects myocardial strain values obtained with STE in intubated critically ill patients. Whenever performing STE in mechanically ventilated patients, care must be taken when PEEP is higher than 10 cmH(2)O to avoid misinterpreting data and making erroneous decisions. Hindawi Publishing Corporation 2013 2013-08-28 /pmc/articles/PMC3771268/ /pubmed/24066303 http://dx.doi.org/10.1155/2013/918548 Text en Copyright © 2013 Federico Franchi et al. https://creativecommons.org/licenses/by/3.0/ This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Clinical Study
Franchi, Federico
Faltoni, Agnese
Cameli, Matteo
Muzzi, Luigi
Lisi, Matteo
Cubattoli, Lucia
Cecchini, Sofia
Mondillo, Sergio
Biagioli, Bonizella
Taccone, Fabio Silvio
Scolletta, Sabino
Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients
title Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients
title_full Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients
title_fullStr Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients
title_full_unstemmed Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients
title_short Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients
title_sort influence of positive end-expiratory pressure on myocardial strain assessed by speckle tracking echocardiography in mechanically ventilated patients
topic Clinical Study
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3771268/
https://www.ncbi.nlm.nih.gov/pubmed/24066303
http://dx.doi.org/10.1155/2013/918548
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