tailieunhanh - Báo cáo y học: "How can the response to volume expansion in patients with spontaneous respiratory movements be predicted"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care cung cấp cho các bạn kiến thức về ngành y đề tài: How can the response to volume expansion in patients with spontaneous respiratory movements be predicted? | Available online http content 10 4 R102 Research How can the response to volume expansion in patients with spontaneous respiratory movements be predicted Sarah Heenen Daniel De Backer and Jean-Louis Vincent Open Access Department of Intensive Care Erasme University Hospital Free University of Brussels Route de Lennik 808 B-1070 Brussels Belgium Corresponding author Daniel De Backer ddebacke@ Received 11 Jan 2006 Revisions requested 31 Jan 2006 Revisions received 8 Jun 2006 Accepted 26 Jun 2006 Published 17 Jul 2006 Critical Care 2006 10 R102 doi cc4970 This article is online at http content 10 4 R1 02 2006 Heenen et al. licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License http licenses by which permits unrestricted use distribution and reproduction in any medium provided the original work is properly cited. Abstract Introduction The aim of the study was to evaluate the ability of different static and dynamic measurements of preload to predict fluid responsiveness in patients with spontaneous respiratory movements. Methods The subjects were 21 critically ill patients with spontaneous breathing movements receiving mechanical ventilation with pressure support mode n 9 or breathing through a face mask n 12 and who required a fluid challenge. Complete hemodynamic measurements including pulmonary artery occluded pressure PAOP right atrial pressure RAP pulse pressure variation APP and inspiratory variation in RAP were obtained before and after fluid challenge. Fluid challenge consisted of boluses of either crystalloid or colloid until cardiac output reached a plateau. Receiver operating characteristics ROC curve analysis was used to evaluate the predictive value of the indices to the response to fluids as defined by an increase in cardiac index of 15 or more. Results Cardiac index increased from to to to l