PT  - JOURNAL ARTICLE
AU  - Bouchra Lamia
AU  - Stephanie Van Mossevelde
AU  - Luis-Carlos Molano
AU  - Antoine Cuvelier
AU  - Jean-Francois Muir
TI  - Hemodynamic consequences of NIV during acute respiratory failure. A prospective echocardiographic study
AID  - 10.1183/13993003.congress-2015.OA500
DP  - 2015 Sep 01
TA  - European Respiratory Journal
PG  - OA500
VI  - 46
IP  - suppl 59
4099  - http://erj.ersjournals.com/content/46/suppl_59/OA500.short
4100  - http://erj.ersjournals.com/content/46/suppl_59/OA500.full
SO  - Eur Respir J2015 Sep 01; 46
AB  - Introduction: In acute respiratory failure patients, the increased negativity of intrathoracic pressure (ITP) during inspiration induces an increase of venous return pressure gradient, right ventricular (RV) afterload and left ventricular ejection pressure gradient. Few studies have non invasively reported hemodynamic effetcs of NIV in acute respiratory faiure pateints. We aimed to analyse with echocardiography such hemodynamic consequences.Méthodes: Prospective study. Transthorcaic echocardiography (TTE) images were recorded during spontaneous breathing activity and during NIV. Parameters of preload, afterload, diastolic function and contractlity were measured. Speckle tracking technic analysis was applied to 2D echo images.Résultats: Thirteen patients were included (69(11) y; 9 CHD and 11 CRD. NIV (ST mode, PS=14(2) cm2 , O2 = 7 (6) L/min.) significantly improved LV systolic function: LVEF: 59(6) vs 66 (6)%, p=0.01 ; SV: 61 (9) vs 65 (12) ml, p = 0.05, LV diastolic function : Ea wave 11(2) vs 9(2), p=0.01, RV afterload : decreased of TR velocity from 3,42 (0,44) to 3,02 (0,57) m/sec, p = 0.01. RV synchrony measured by seckle tracking strain was also improved: 235 (140) vs 182 (149) msec, p =0.04.Conclusion: During acute respiratory failure preload, afterload and contractility are affected. In our study TTE analysis showed marked improvement in LV and RV function and better understanding of NIV induced heart lung interactions for a best treatment adjustment.