tailieunhanh - Báo cáo khoa học: "Changes in aortic blood flow induced by passive leg raising predict fluid responsiveness in critically ill patients"

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: Changes in aortic blood flow induced by passive leg raising predict fluid responsiveness in critically ill patients. | Available online http content 10 5 R132 Open Access Research Changes in aortic blood flow induced by passive leg raising predict fluid responsiveness in critically ill patients A Lafanechere F Pène C Goulenok A Delahaye V Mallet G Choukroun JD Chiche JP Mira and A Cariou Medical Intensive Care Unit Cochin Hospital APHP Université Paris Descartes 27 rue du Faubourg Saint Jacques 75679 Paris Cedex 14 France Corresponding author A Cariou Received 10 Mar 2006 Revisions requested 10 Apr 2006 Revisions received 28 Aug 2006 Accepted 13 Sep 2006 Published 13 Sep 2006 Critical Care 2006 10 R132 doi cc5044 This article is online at http content 10 5 R132 2006 Lafanechere 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 Esophageal Doppler provides a continuous and non-invasive estimate of descending aortic blood flow ABF and corrected left ventricular ejection time LVETc . Considering passive leg raising PLR as a reversible volume expansion VE we compared the relative abilities of PLR-induced ABF variations LVETc and respiratory pulsed pressure variations APP to predict fluid responsiveness. Methods We studied 22 critically ill patients in acute circulatory failure in the supine position during PLR back to the supine position and after two consecutive VEs of 250 ml of saline. Responders were defined by an increase in ABF induced by 500 ml VE of more than 15 . Results Ten patients were responders and 12 were nonresponders. In responders the increase in ABF induced by PLR was similar to that induced by a 250 ml VE 16 versus 20 p . A PLR-induced increase in ABF of more than 8 predicted fluid responsiveness with a sensitivity of 90 and a specificity