Right ventricular end-diastolic volume index as a predictor of preload status in patients on positive end-expiratory pressure
| Autor: | Loren D. Nelson, Michael C. Chang, Michael L. Cheatham, Karen Safcsak |
|---|---|
| Rok vydání: | 1998 |
| Předmět: |
Adult
Adolescent Critical Care Positive pressure Diastole Hemodynamics Critical Care and Intensive Care Medicine Cohort Studies Positive-Pressure Respiration Humans Medicine Prospective Studies Hypoxia Pulmonary wedge pressure Positive end-expiratory pressure Aged Aged 80 and over business.industry Stroke Volume Stroke volume Middle Aged Prognosis Preload Respiratory failure Anesthesia Acute Disease Ventricular Function Right cardiovascular system Respiratory Insufficiency business |
| Zdroj: | Critical Care Medicine. 26:1801-1806 |
| ISSN: | 0090-3493 |
| DOI: | 10.1097/00003246-199811000-00017 |
| Popis: | To evaluate the clinical utility of right ventricular end-diastolic volume index (RVEDVI) and pulmonary artery occlusion pressure (PAOP) as measures of preload status in patients with acute respiratory failure receiving treatment with positive end-expiratory pressure.Prospective, cohort study.Surgical intensive care unit in a Level I trauma center/university hospital.Sixty-four critically ill surgical patients with acute respiratory failure.All patients were treated for acute respiratory failure with titrated levels of positive end-expiratory pressure (PEEP) with the goal of increasing arterial oxygen saturation toor =0.92, reducing FIO2 to0.5, and reducing intrapulmonary shunt toor =0.2. Serial determinations of RVEDVI, PAOP, and cardiac index (CI) were recorded.Two hundred-fifty sets of hemodynamic variables were measured in 64 patients. The level of PEEP ranged from 5 to 50 cm H2O (mean 12+/-9 [SD] cm H2O). At all levels of PEEP, CI correlated significantly better with RVEDVI than with PAOP. At levels of PEEPor =15 cm H2O, CI was inversely correlated with PAOP, but remained positively correlated with RVEDVI.CI correlates significantly better with RVEDVI than PAOP at all levels of PEEP up to 50 cm H2O. RVEDVI is a more reliable predictor of volume depletion and preload recruitable increases in CI, especially in patients receiving higher levels of PEEP where PAOP is difficult to interpret. |
| Databáze: | OpenAIRE |
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