BMC Cardiovascular Disorders | |
Arterial dP/dtmax accurately reflects left ventricular contractility during shock when adequate vascular filling is achieved | |
Vincent D'Orio2  Geoffrey Chase1  Nathalie Janssen2  Thomas Desaive3  Bernard Lambermont4  Philippe Morimont4  | |
[1] Mechanical Engineering Department, University of Canterbury, Christchurch, New Zealand;Emergency Department, University Hospital of Liège, Liège, Belgium;Faculty of Sciences, University of Liège, Liège, Belgium;Medical Intensive Care Unit, University Hospital of Liège, Liège, Belgium | |
关键词: Endotoxin-induced shock; Preload responsiveness; Septic cardiomyopathy; Aortic pressure; Left ventricular function; | |
Others : 1085263 DOI : 10.1186/1471-2261-12-13 |
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received in 2011-09-01, accepted in 2012-03-01, 发布年份 2012 | |
【 摘 要 】
Background
Peak first derivative of femoral artery pressure (arterial dP/dtmax) derived from fluid-filled catheter remains questionable to assess left ventricular (LV) contractility during shock. The aim of this study was to test if arterial dP/dtmax is reliable for assessing LV contractility during various hemodynamic conditions such as endotoxin-induced shock and catecholamine infusion.
Methods
Ventricular pressure-volume data obtained with a conductance catheter and invasive arterial pressure obtained with a fluid-filled catheter were continuously recorded in 6 anaesthetized and mechanically ventilated pigs. After a stabilization period, endotoxin was infused to induce shock. Catecholamines were transiently administrated during shock. Arterial dP/dtmax was compared to end-systolic elastance (Ees), the gold standard method for assessing LV contractility.
Results
Endotoxin-induced shock and catecholamine infusion lead to significant variations in LV contractility. Overall, significant correlation (r = 0.51; p < 0.001) but low agreement between the two methods were observed. However, a far better correlation with a good agreement were observed when positive-pressure ventilation induced an arterial pulse pressure variation (PPV) ≤ 11% (r = 0.77; p < 0.001).
Conclusion
While arterial dP/dtmax and Ees were significantly correlated during various hemodynamic conditions, arterial dP/dtmax was more accurate for assessing LV contractility when adequate vascular filling, defined as PPV ≤ 11%, was achieved.
【 授权许可】
2012 Morimont et al; licensee BioMed Central Ltd.
【 预 览 】
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