Dynamic arterial elastance as a predictor of arterial pressure response to fluid administration: a validation study
| Autor: | R. M. Grounds, Hollmann D. Aya, Maurizio Cecconi, Manuel Gracia Romero, Andrew Rhodes, Manuel Ignacio Monge García, Anselmo Gil Cano |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
medicine.medical_specialty Mean arterial pressure Pathology Fluid administration Validation study Critical Care and Intensive Care Medicine Predictive Value of Tests Internal medicine Volume expansion medicine Humans Arterial Pressure Prospective Studies Cardiac Output Aged business.industry Research Stroke Volume Stroke volume Middle Aged Respiration Artificial Pulse pressure Blood pressure Arterial elastance Cardiology Fluid Therapy Female business Blood Flow Velocity |
| Zdroj: | Critical Care |
| ISSN: | 1466-609X |
| Popis: | Introduction Functional assessment of arterial load by dynamic arterial elastance (Eadyn), defined as the ratio between pulse pressure variation (PPV) and stroke volume variation (SVV), has recently been shown to predict the arterial pressure response to volume expansion (VE) in hypotensive, preload-dependent patients. However, because both SVV and PPV were obtained from pulse pressure analysis, a mathematical coupling factor could not be excluded. We therefore designed this study to confirm whether Eadyn, obtained from two independent signals, allows the prediction of arterial pressure response to VE in fluid-responsive patients. Methods We analyzed the response of arterial pressure to an intravenous infusion of 500 ml of normal saline in 53 mechanically ventilated patients with acute circulatory failure and preserved preload dependence. Eadyn was calculated as the simultaneous ratio between PPV (obtained from an arterial line) and SVV (obtained by esophageal Doppler imaging). A total of 80 fluid challenges were performed (median, 1.5 per patient; interquartile range, 1 to 2). Patients were classified according to the increase in mean arterial pressure (MAP) after fluid administration in pressure responders (≥10%) and non-responders. Results Thirty-three fluid challenges (41.2%) significantly increased MAP. At baseline, Eadyn was higher in pressure responders (1.04 ± 0.28 versus 0.60 ± 0.14; P |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full text from SpringerLink