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Báo cáo khoa học: "Echocardiography and assessing fluid responsiveness: acoustic quantification again into the picture"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Echocardiography and assessing fluid responsiveness: acoustic quantification again into the picture? | Available online http ccforum.eom content 11 1 105 Commentary Echocardiography and assessing fluid responsiveness acoustic quantification again into the picture Jan Poelaert and Carl Roosens University Hospital Ghent Department of Intensive Care Medicine and Cardiac Anaesthesia De Pintelaan B-9000 Gent Belgium Correspondence Jan Poelaert jan.poelaert@ugent.be Published 23 January 2007 This article is online at http ccforum.com content 11 1 105 2007 BioMed Central Ltd Critical Care 2007 11 105 doi 10.1186 cc5140 See related research by Cannesson et al. http ccforum.com content 10 6 R171 Abstract Accurate identification of fluid responsiveness has become an important issue in critically ill patients. Pulse pressure and stroke volume variation have been shown to be reliable predictors of fluid responsiveness. Apart from these two valuable techniques echo-Doppler offers an interesting alternative for estimating the adequacy of filling. Acoustic quantification is a high-tech tool for delineating the blood-tissue interface on-screen in real time. Cannesson and coworkers utilized this technique in ventilated patients to assess stroke area changes with the intention being to predict fluid responsiveness. Optimization of haemodynamics in critically ill patients necessitates a critical balance between cardiac preload afterload and myocardial performance. In this context assessment of fluid responsiveness remains difficult especially in haemodynamically unstable patients. Many researchers have invested their experience in developing reproducible methods to predict optimal preload safely and adequately. Furthermore echocardiography may be helpful in estimating fluid responsiveness 1 . Alterations in intra-thoracic pressures during mechanical ventilation are known to induce cyclic variations in preloading conditions of the right and left ventricles resulting in discrete changes in stroke volume and hence in arterial pressure 2 . Significant ventilation-induced undulations in .