Downstream Effects: Promise and Challenges of Femoral Vein Pulsatility Assessment

The postoperative course of patients undergoing major cardiovascular and thoracic surgery can be greatly dictated by the state of the right ventricle. Cardiac surgery often involves an onslaught of physiologic derangements, including wide swings of preload and afterload, pulmonary vascular changes, due to alterations in acid —base balance, hypoxia, and hypercarbia, dysrhythmias, and direct mechanical compression and interference that can make the task of the right ventricle incredibly daunting. Intraoperatively, the assessment of the right ventricle is performed under direct visualization in the surgical field and via transesophageal echocardiography, whereas invasive central venous or pulmonary artery catheterization, with continuous cardiac output and mixed venous monitoring capabilities, offer a continuous but more indirect view of right ventricular stressors in the intensive care unit.
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Editorial Source Type: research