Volatile anaesthetics and positive pressure ventilation reduce left atrial performance: a transthoracic echocardiographic study in young healthy adults

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Volatile anaesthetics and positive pressure ventilation reduce left atrial performance: a transthoracic echocardiographic study in young healthy adults D. Freiermuth, K. Skarvan, M. Filipovic, M.D. Seeberger, D. Bolliger British Journal of Anaesthesia Volume 112, Issue 6, Pages 1032-1041 (June 2014) DOI: 10.1093/bja/aet583 Copyright © 2014 The Author(s) Terms and Conditions

Fig 1 LA area and TDI parameters at baseline and during positive pressure ventilation. The upper row shows maximum and minimum LA area in the apical four-chamber view as tissue Doppler parameters in the awake patient (baseline). The lower row shows the corresponding LA areas and tissue Doppler parameters during anaesthesia with volatile anaesthetics and positive pressure ventilation (step II). LA, left atrium; TD, tissue Doppler; a′, late peak diastolic velocity of the mitral annulus; e′, early peak diastolic velocity of the mitral annulus; s′, peak systolic velocity of the mitral annulus. British Journal of Anaesthesia 2014 112, 1032-1041DOI: (10.1093/bja/aet583) Copyright © 2014 The Author(s) Terms and Conditions

Fig 2 Percentage changes of reservoir, contractile, and conduit volumes compared with baseline. Whereas reservoir volume decreased significantly only in step II (volatile anaesthetic and positive pressure ventilation), LA active emptying volume decreased significantly in both step I (volatile anaesthetic and spontaneous breathing) and step II. Conduit volume did not change significantly during steps I and II. *P<0.025 vs baseline; †P<0.025 vs step I. British Journal of Anaesthesia 2014 112, 1032-1041DOI: (10.1093/bja/aet583) Copyright © 2014 The Author(s) Terms and Conditions

Fig 3 Comparative changes of pump function and dimensions between LA and LV. LA pump function as evaluated by late peak diastolic velocity of the mitral annulus (a′) and LA fractional area change (FAC) was significantly more impaired than LV pump function as evaluated by peak systolic velocity of the mitral annulus (s′) and LV FAC. Maximum LA area and end-diastolic area (EDA) of the LV were similarly affected by volatile anaesthetics during spontaneous breathing and IPPV. British Journal of Anaesthesia 2014 112, 1032-1041DOI: (10.1093/bja/aet583) Copyright © 2014 The Author(s) Terms and Conditions