{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,28]],"date-time":"2026-09-28T15:23:43Z","timestamp":1790609023193,"version":"4.1.0"},"reference-count":28,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T00:00:00Z","timestamp":1718928000000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T00:00:00Z","timestamp":1718928000000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100001734","name":"Copenhagen University","doi-asserted-by":"crossref","id":[{"id":"10.13039\/501100001734","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Clin Monit Comput"],"published-print":{"date-parts":[[2024,10]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>General Anaesthesia (GA) is accompanied by a marked decrease in sympathetic outflow and thus loss of vasomotor control of cardiac preload. The use of vasoconstriction during GA has mainly focused on maintaining blood pressure. Phenylephrine (PE) is a pure \u03b11-agonist without inotropic effects widely used to correct intraoperative hypotension. The potential of PE for augmenting cardiac stroke volume (SV) and -output (CO) by venous recruitment is controversial and no human studies have explored the effects of PE in preload dependent circulation using indicator dilution technique. We hypothesized that PE-infusion in patients with cardiac stroke volume limited by reduced preload would restore preload and thus augment SV and CO. 20 patients undergoing GA for gastrointestinal surgery were monitored with arterial catheter and LiDCO unity monitor. Upon stable haemodynamics after induction patients were placed in head-up tilt (HUT). All patients became preload responsive as verified by a stroke volume variation (SVV) of &gt;\u200912%. PE-infusion was then started at 15-20mikrg\/min and adjusted until preload was restored (SVV\u2009&lt;\u200912%). Li-dilution cardiac output (CO) was initially measured after induction (baseline), again with HUT in the preload responsive phase, and finally when preload was restored with infusion of PE.At baseline SVV was 10\u2009\u00b1\u20093% (mean\u2009\u00b1\u2009st.dev.), CI was 2,6\u2009\u00b1\u20090,4\u00a0L\/min*m<jats:sup>2<\/jats:sup>, and SVI 43\u2009\u00b1\u20097mL\/m<jats:sup>2<\/jats:sup>. With HUT SVV was 19\u2009\u00b1\u20094%, CI was 2,2\u2009\u00b1\u20090,4\u00a0L\/min*m<jats:sup>2<\/jats:sup>, SVI 35\u2009\u00b1\u20097mL\/m<jats:sup>2<\/jats:sup>. During PE-infusion SVV was reduced to 6\u2009\u00b1\u20093%, CI increased to 2,6\u2009\u00b1\u20090,5\u00a0L\/min*m<jats:sup>2<\/jats:sup>, and SVI increased to 49\u2009\u00b1\u200911mL\/m<jats:sup>2<\/jats:sup>. All differences <jats:italic>p<\/jats:italic>\u2009&lt;\u20090,001. In conclusion:\u00a0Infusion of phenylephrine during preload dependency increased venous return abolishing preload dependency as evaluated by SVV and increased cardiac stroke volume and -output as measured by indicator-dilution technique. (ClinicalTrials.gov NCT05193097).<\/jats:p>","DOI":"10.1007\/s10877-024-01186-7","type":"journal-article","created":{"date-parts":[[2024,6,21]],"date-time":"2024-06-21T16:02:45Z","timestamp":1718985765000},"page":"997-1002","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Vasoconstriction with phenylephrine increases cardiac output in preload dependent patients"],"prefix":"10.1007","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9904-6206","authenticated-orcid":false,"given":"Jakob","family":"H\u00f8jlund","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mirjana","family":"Cihoric","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolai Bang","family":"Foss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2024,6,21]]},"reference":[{"key":"1186_CR1","doi-asserted-by":"publisher","first-page":"317","DOI":"10.1097\/ALN.0000000000001985","volume":"128","author":"DI Sessler","year":"2018","unstructured":"Sessler DI, Meyhoff CS, Zimmerman NM, Mao G, Leslie K, V\u00e1squez SM, et al. Period-dependent associations between hypotension during and for four days after noncardiac surgery and a composite of myocardial infarction and death. Anesthesiology. 2018;128:317\u201327.","journal-title":"Anesthesiology"},{"key":"1186_CR2","doi-asserted-by":"publisher","first-page":"341","DOI":"10.1007\/s10877-021-00653-9","volume":"36","author":"B Saugel","year":"2022","unstructured":"Saugel B, Bebert E-J, Briesenick L, Hoppe P, Greiwe G, Yang D, et al. Mechanisms contributing to hypotension after anesthetic induction with sufentanil, propofol, and rocuronium: a prospective observational study. J Clin Monit Comput. 2022;36:341\u20137.","journal-title":"J Clin Monit Comput"},{"key":"1186_CR3","doi-asserted-by":"publisher","first-page":"416","DOI":"10.1016\/j.bja.2021.10.046","volume":"128","author":"MK Jessen","year":"2022","unstructured":"Jessen MK, Vallentin MF, Holmberg MJ, Bolther M, Hansen FB, Holst JM, et al. Goal-directed haemodynamic therapy during general anaesthesia for noncardiac surgery: a systematic review and meta-analysis. Br J Anaesth. 2022;128:416\u201333.","journal-title":"Br J Anaesth"},{"key":"1186_CR4","doi-asserted-by":"publisher","first-page":"843","DOI":"10.1177\/0885066620917630","volume":"36","author":"JC Jentzer","year":"2021","unstructured":"Jentzer JC, Hollenberg SM. Vasopressor and inotrope therapy in cardiac critical care. J Intensive Care Med. 2021;36:843\u201356.","journal-title":"J Intensive Care Med"},{"key":"1186_CR5","doi-asserted-by":"publisher","first-page":"373","DOI":"10.1007\/s10877-018-0225-1","volume":"33","author":"R Jacobs","year":"2019","unstructured":"Jacobs R, Lochy S, Malbrain MLNG. Phenylephrine-induced recruitable preload from the venous side. J Clin Monit Comput. 2019;33:373\u20136.","journal-title":"J Clin Monit Comput"},{"key":"1186_CR6","doi-asserted-by":"publisher","first-page":"281","DOI":"10.1152\/japplphysiol.00126.2012","volume":"113","author":"M Cannesson","year":"2012","unstructured":"Cannesson M, Jian Z, Chen G, Vu TQ, Hatib F. Effects of phenylephrine on cardiac output and venous return depend on the position of the heart on the Frank-Starling relationship. J Appl Physiol. 2012;113:281\u20139.","journal-title":"J Appl Physiol"},{"key":"1186_CR7","doi-asserted-by":"publisher","first-page":"969","DOI":"10.1007\/s10877-018-0126-3","volume":"32","author":"AF Kalmar","year":"2018","unstructured":"Kalmar AF, Allaert S, Pletinckx P, Maes J-W, Heerman J, Vos JJ, et al. Phenylephrine increases cardiac output by raising cardiac preload in patients with anesthesia induced hypotension. J Clin Monit Comput. 2018;32:969\u201376.","journal-title":"J Clin Monit Comput"},{"key":"1186_CR8","doi-asserted-by":"publisher","first-page":"638","DOI":"10.1097\/EJA.0000000000000470","volume":"33","author":"O Rebet","year":"2016","unstructured":"Rebet O, Andremont O, G\u00e9rard J-L, Fellahi J-L, Hanouz J-L, Fischer M-O. Preload dependency determines the effects of phenylephrine on cardiac output in anaesthetised patients. Eur J Anaesthesiol. 2016;33:638\u201344.","journal-title":"Eur J Anaesthesiol"},{"key":"1186_CR9","doi-asserted-by":"publisher","first-page":"1177","DOI":"10.1007\/s10877-019-00420-x","volume":"34","author":"J H\u00f8jlund","year":"2020","unstructured":"H\u00f8jlund J, Agerskov M, Clemmesen CG, Hvolris LE, Foss NB. The peripheral perfusion index tracks systemic haemodynamics during general anaesthesia. J Clin Monit Comput. 2020;34:1177\u201384.","journal-title":"J Clin Monit Comput"},{"key":"1186_CR10","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1213\/01.ane.0000268140.02147.ed","volume":"105","author":"B Bein","year":"2007","unstructured":"Bein B, Meybohm P, Cavus E, Renner J, Tonner PH, Steinfath M, et al. The reliability of pulse contour-derived cardiac output during hemorrhage and after vasopressor administration. Anesth Analg. 2007;105:107\u201313.","journal-title":"Anesth Analg"},{"key":"1186_CR11","doi-asserted-by":"publisher","first-page":"6","DOI":"10.4103\/aca.ACA_41_18","volume":"22","author":"J Kobe","year":"2019","unstructured":"Kobe J, Mishra N, Arya VK, Al-Moustadi W, Nates W, Kumar B. Cardiac output monitoring: technology and choice. Ann Card Anaesth. 2019;22:6.","journal-title":"Ann Card Anaesth"},{"key":"1186_CR12","doi-asserted-by":"publisher","first-page":"1014","DOI":"10.1177\/0310057X1103900606","volume":"39","author":"TD Phan","year":"2011","unstructured":"Phan TD, Kluger R, Wan C, Wong D, Padayachee A. A comparison of three minimally invasive cardiac output devices with thermodilution in elective cardiac surgery. Anaesth Intensive Care. 2011;39:1014\u201321.","journal-title":"Anaesth Intensive Care"},{"key":"1186_CR13","doi-asserted-by":"publisher","first-page":"590","DOI":"10.1111\/aas.12905","volume":"61","author":"F Vall\u00e9e","year":"2017","unstructured":"Vall\u00e9e F, Passouant O, Le Gall A, Joachim J, Mateo J, Mebazaa A, et al. Norepinephrine reduces arterial compliance less than phenylephrine when treating general anesthesia-induced arterial hypotension. Anaesthesiologica Scand. 2017;61:590\u2013600.","journal-title":"Anaesthesiologica Scand"},{"key":"1186_CR14","doi-asserted-by":"publisher","first-page":"297","DOI":"10.1213\/ANE.0b013e3182120ca5","volume":"113","author":"RH Thiele","year":"2011","unstructured":"Thiele RH, Nemergut EC, Lynch C. The clinical implications of isolated alpha1 adrenergic stimulation. Anesth Analg. 2011;113:297\u2013304.","journal-title":"Anesth Analg"},{"key":"1186_CR15","doi-asserted-by":"publisher","first-page":"271","DOI":"10.1186\/s13054-016-1438-7","volume":"20","author":"S Magder","year":"2016","unstructured":"Magder S. Volume and its relationship to cardiac output and venous return. Crit Care. 2016;20:271\u201381.","journal-title":"Crit Care"},{"key":"1186_CR16","doi-asserted-by":"publisher","first-page":"190","DOI":"10.1186\/cc2852","volume":"8","author":"RM Pearse","year":"2004","unstructured":"Pearse RM, Ikram K, Barry J. Equipment review: an appraisal of the LiDCOTMplus method of measuring cardiac output. Crit Care. 2004;8:190\u20135.","journal-title":"Crit Care"},{"key":"1186_CR17","doi-asserted-by":"publisher","first-page":"770","DOI":"10.1093\/bja\/79.6.770","volume":"79","author":"T Kurita","year":"1997","unstructured":"Kurita T, Morita K, Kato S, Kikura M, Horie M, Ikeda K. Comparison of the accuracy of the lithium dilution technique with the thermodilution technique for measurement of cardiac output. Br J Anaesth. 1997;79:770\u20135.","journal-title":"Br J Anaesth"},{"key":"1186_CR18","doi-asserted-by":"publisher","first-page":"1796","DOI":"10.1097\/00003246-199711000-00015","volume":"25","author":"R Linton","year":"1997","unstructured":"Linton R, Band D, O\u2019Brien T, Jonas M, Leach R. Lithium dilution cardiac output measurement: a comparison with thermodilution. Crit Care Med. 1997;25:1796\u2013800.","journal-title":"Crit Care Med"},{"key":"1186_CR19","first-page":"1113","volume":"109","author":"M Neukirchen","year":"2008","unstructured":"Neukirchen M, Kienbaum P. Sympathetic nervous system. Anesthesiology. 2008;109:1113\u201331.","journal-title":"Sympathetic Nerv Syst Anesthesiology"},{"key":"1186_CR20","doi-asserted-by":"publisher","first-page":"336","DOI":"10.1111\/j.1399-6576.1992.tb03478.x","volume":"36","author":"J Sellgren","year":"1992","unstructured":"Sellgren J, Pont\u00e9n J, Wallin BG. Characteristics of muscle nerve sympathetic activity during general anaesthesia in humans. Acta Anaesthesiol Scand. 1992;36:336\u201345.","journal-title":"Acta Anaesthesiol Scand"},{"key":"1186_CR21","doi-asserted-by":"publisher","first-page":"267","DOI":"10.1034\/j.1399-6576.2003.00073.x","volume":"47","author":"K Myre","year":"2003","unstructured":"Myre K, R\u00e1der J, Rostrup M, Buanes T, Stokland O. Catecholamine release during laparoscopic fundoplication with high and low doses of remifentanil. Acta Anaesthesiol Scand. 2003;47:267\u201373.","journal-title":"Acta Anaesthesiol Scand"},{"key":"1186_CR22","doi-asserted-by":"publisher","first-page":"282","DOI":"10.1186\/cc710","volume":"4","author":"F Michard","year":"2000","unstructured":"Michard F, Teboul J-L. Using heart-lung interactions to assess fluid responsiveness during mechanical ventilation. Crit Care. 2000;4:282\u20139.","journal-title":"Crit Care"},{"key":"1186_CR23","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13054-015-0932-7","volume":"19","author":"JL Vincent","year":"2015","unstructured":"Vincent JL, Pelosi P, Pearse R, Payen D, Perel A, Hoeft A, et al. Perioperative cardiovascular monitoring of high-risk patients: a consensus of 12. Crit Care. 2015;19:1\u201312.","journal-title":"Crit Care"},{"key":"1186_CR24","doi-asserted-by":"publisher","first-page":"609","DOI":"10.1152\/ajplegacy.1957.189.3.609","volume":"189","author":"AC GUYTON","year":"1957","unstructured":"Guyton AC, Lindsey AW, Richardson Abernathyb. Venous return at various right atrial pressures and the normal venous return curve. Am J Physiol. 1957;189:609\u201315.","journal-title":"Am J Physiol"},{"key":"1186_CR25","doi-asserted-by":"publisher","first-page":"1182","DOI":"10.1161\/01.RES.8.6.1182","volume":"8","author":"S VARMA","year":"1960","unstructured":"Varma S, Johnsen SD, Sherman DE, Youmans WB. Mechanisms of inhibition of heart rate by phenylephrine. Circ Res. 1960;8:1182\u20136.","journal-title":"Circ Res"},{"key":"1186_CR26","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1186\/2046-7648-3-1","volume":"3","author":"MR Edwards","year":"2014","unstructured":"Edwards MR, Mythen MG. Fluid therapy in critical illness. Extrem Physiol Med BioMed Cent Ltd. 2014;3:1\u20139.","journal-title":"Extrem Physiol Med BioMed Cent Ltd"},{"key":"1186_CR27","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s12893-016-0203-9","volume":"17","author":"T Glatz","year":"2017","unstructured":"Glatz T, Kulemann B, Marjanovic G, Bregenzer S, Makowiec F, Hoeppner J. Postoperative fluid overload is a risk factor for adverse surgical outcome in patients undergoing esophagectomy for esophageal cancer: a retrospective study in 335 patients. BMC Surg. 2017;17:1\u201310.","journal-title":"BMC Surg"},{"key":"1186_CR28","doi-asserted-by":"publisher","first-page":"100","DOI":"10.1016\/j.bja.2019.04.052","volume":"123","author":"NB Foss","year":"2019","unstructured":"Foss NB, Kehlet H. Perioperative haemodynamics and vasoconstriction: time for reconsideration? Br J Anaesth. 2019;123:100\u20133.","journal-title":"Br J Anaesth"}],"container-title":["Journal of Clinical Monitoring and Computing"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10877-024-01186-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10877-024-01186-7\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10877-024-01186-7.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,9,26]],"date-time":"2024-09-26T09:06:50Z","timestamp":1727341610000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10877-024-01186-7"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,6,21]]},"references-count":28,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2024,10]]}},"alternative-id":["1186"],"URL":"https:\/\/doi.org\/10.1007\/s10877-024-01186-7","relation":{},"ISSN":["1387-1307","1573-2614"],"issn-type":[{"value":"1387-1307","type":"print"},{"value":"1573-2614","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,6,21]]},"assertion":[{"value":"16 April 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 June 2024","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"21 June 2024","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The study was approved by the regional ethics committee for the Capital Region of Denmark (H-21032981) and registered at ClinicalTrials.gov (NCT05193097). Processing of personal data was approved by the Danish Data Protection Agency (AHH-2016-095). All patients gave oral and written consent to participate.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethics approval"}},{"value":"NBF has received speaker fees from MASIMO. (MASIMO has recently purchased LiDCO)","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}