tailieunhanh - Báo cáo y học: "Endothelial Cardiac filling volumes versus pressures for predicting fluid responsiveness after cardiovascular surgery: the role of systolic cardiac function"

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: Endothelial Cardiac filling volumes versus pressures for predicting fluid responsiveness after cardiovascular surgery: the role of systolic cardiac function. | Trof et al. Critical Care 2011 15 R73 http content 15 1 R73 KS CRITICAL CARE RESEARCH Open Access Cardiac filling volumes versus pressures for predicting fluid responsiveness after cardiovascular surgery the role of systolic cardiac function Ronald J Trof1 2 Ibrahim Danad 1 Mikel WL Reilingh1 Rose-Marieke BGE Breukers1 and AB Johan Groeneveld1 Abstract Introduction Static cardiac filling volumes have been suggested to better predict fluid responsiveness than filling pressures but this may not apply to hearts with systolic dysfunction and dilatation. We evaluated the relative value of cardiac filling volume and pressures for predicting and monitoring fluid responsiveness according to systolic cardiac function estimated by global ejection fraction GEF normal 25 to 35 from transpulmonary thermodilution. Methods We studied hypovolemic mechanically ventilated patients after coronary n 18 or major vascular n 14 surgery in the intensive care unit. We evaluated 96 colloid fluid loading events 200 to 600 mL given in three consecutive 30-minute intervals guided by increases in filling pressures divided into groups of responding events fluid responsiveness and non-responding events in patients with low GEF 20 or near-normal GEF 20 . Patients were monitored by transpulmonary dilution and central venous n 9 pulmonary artery n 23 catheters to obtain cardiac index CI global end-diastolic volume index GEDVI central venous CVP and pulmonary artery occlusion pressure PAOP . Results Fluid responsiveness occurred in 8 15 increase in CI and 17 10 increase in CI of 36 fluid loading events when GEF was 20 and 7 15 increase in CI and 17 10 increase in CI of 60 fluid loading events when GEF was 20 . Whereas a low baseline GEDVI predicted fluid responsiveness particularly when GEF was 20 P or lower a low PAOP was of predictive value particularly when GEF was 20 P or lower . The baseline CVP was lower in responding events regardless of GEF. Changes in CVP and PAOP .