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Global longitudinal strain changes during hemorrhagic shock: An experimental study
Laurent Zieleskiewicz1, Pierre-Géraud Claret2, Laurent Muller2, Jean Emmanuel de La Coussaye2, Jean Yves Lefrant2, Iris Schuster3, Claire Roger2, Xavier Bobbia2
1 Department of Anesthesiology and Intensive Care, North Hospital, APHM, Aix Marseille Univ., INSERM, INRA, C2VN, Marseille, France
2 Department of Anesthesiology, Critical Care, Montpellier University, Pain and Emergency Medicine, Nîmes University Hospital; Faculty of Medicine, Montpellier-Nimes University,EA 2992, Nîmes, France
3 Department of Sports Medicine and Cardiology (CEMAPS 30), Nîmes University Hospital and PhyMedExp, INSERM U1046, CNRS UMR9214, Montpellier University, Montpellier, France
Correspondence Address:
Dr. Xavier Bobbia
Department of Anesthesiology, Critical Care, Pain and Emergency Medicine, Nîmes University Hospital, Place du Pr. Robert Debré, 30029 Nîmes
France
 Source of Support: None, Conflict of Interest: None  | 3 |
DOI: 10.4103/2452-2473.290066
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OBJECTIVES: Global longitudinal strain (GLS) appears sensitive and reproducible to identify left ventricular systolic dysfunction. The main objective was to analyze the GLS changes in an anesthetized-piglet model of controlled hemorrhagic shock (HS). The secondary objective was to evaluate if GLS changes was different depending on the expansion fluid treatment with or without norepinephrine.
METHODS: Eighteen anesthetized and ventilated piglets were bled until the mean arterial pressure reached 40 mmHg. Controlled hemorrhage was maintained for 30 min before randomizing the piglets to three resuscitation groups: control group, LR group (resuscitated with lactated ringer), and NA group (resuscitated with lactated ringer and norepinephrine).
RESULTS: There was no difference in the baseline hemodynamic, biological, and ultrasound data among the three groups. During the hemorrhagic phase, the GLS increased significantly from 25 mL/kg of depletion. During the resuscitation phase, the GLS decreased significantly from 20 mL/kg of fluid administration. There was no difference in GLS variation among the groups during the hemorrhagic, maintenance, and resuscitation phases.
CONCLUSION: In our HS model, GLS increased with hemorrhage and decreased during resuscitation, showing its preload dependence.
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