An observational study found reduced longitudinal measures while global right-ventricular ejection measures were preserved.
The before-after findings
Fifty-three cardiac-surgery patients underwent echocardiography before and immediately after anesthesia induction and initiation of positive-pressure ventilation. The regimen included midazolam, sufentanil, rocuronium, and subsequently sevoflurane. Longitudinal right-ventricular measures decreased, while global ejection fraction and stroke volume did not significantly change.
The measurements therefore did not support a single unqualified statement that all right-ventricular function worsened or remained unchanged.
Several changes occurred together
The study cannot isolate midazolam from ventilation, other medicines, loading conditions, or the underlying cardiac disease. Missing measures and a single-center sample further constrain inference.
For review, name the specific cardiac parameter and retain its timing relative to induction. The paper describes physiology under a combined intervention, not a drug-specific cardiotoxicity test. It does not establish the clinical importance of the observed differences in every patient.
Source paper
Original analysis of the supplied journal article, identified as PMC6829832.
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