Influence of changes in ventricular systolic function and loading conditions on pulse contour analysis-derived femoral dP/dtmax
Autor: | Sergi Vaquer, Xavier Monnet, Umar Ahmad, Joan Carles Oliva, Flora Cipriani, Jean-Louis Teboul, Antonio Artigas, Denis Chemla, F. Baigorri, A. Ochagavía |
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Jazyk: | angličtina |
Rok vydání: | 2019 |
Předmět: |
medicine.medical_specialty
Ejection fraction Thermodilution Afterload Critical Care and Intensive Care Medicine Preload 03 medical and health sciences 0302 clinical medicine Internal medicine medicine Systole business.industry Research lcsh:Medical emergencies. Critical care. Intensive care. First aid 030208 emergency & critical care medicine lcsh:RC86-88.9 Pulse pressure Compliance (physiology) Blood pressure 030228 respiratory system Cardiology cardiovascular system Haemodynamic monitoring Dobutamine business Waveform analysis medicine.drug circulatory and respiratory physiology |
Zdroj: | Annals of Intensive Care Annals of Intensive Care, Vol 9, Iss 1, Pp 1-10 (2019) Dipòsit Digital de Documents de la UAB Universitat Autònoma de Barcelona |
ISSN: | 2110-5820 |
Popis: | Background Femoral dP/dtmax (maximum rate of the arterial pressure increase during systole) measured by pulse contour analysis has been proposed as a surrogate of left ventricular (LV) dP/dtmax and as an estimator of LV systolic function. However, femoral dP/dtmax may be influenced by LV loading conditions. In this study, we evaluated the impact of variations of LV systolic function, preload and afterload on femoral dP/dtmax in critically ill patients with cardiovascular failure to ascertain its reliability as a marker of LV systolic function. Results We performed a prospective observational study to evaluate changes in femoral dP/dtmax, thermodilution-derived variables (PiCCO2—Pulsion Medical Systems, Feldkirchen, Germany) and LV ejection fraction (LVEF) measured by transthoracic echocardiography during variations in dobutamine and norepinephrine doses and during volume expansion (VE) and passive leg raising (PLR). Correlations with arterial pulse and systolic pressure, effective arterial elastance, total arterial compliance and LVEF were also evaluated. In absolute values, femoral dP/dtmax deviated from baseline by 21% (201 ± 297 mmHg/s; p = 0.013) following variations in dobutamine dose (n = 17) and by 15% (177 ± 135 mmHg/s; p |
Databáze: | OpenAIRE |
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