tailieunhanh - Báo cáo y học: "Pulmonary artery occlusion pressure estimation by transesophageal echocardiography: is simpler better"

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: Pulmonary artery occlusion pressure estimation by transesophageal echocardiography: is simpler better? | Available online http content 12 2 127 Commentary Pulmonary artery occlusion pressure estimation by transesophageal echocardiography is simpler better Gorazd Voga Medical ICU General Hospital Celje Oblakova 5 3000 Celje Slovenia Corresponding author Gorazd Voga Published 31 March 2008 This article is online at http content 12 2 127 2008 BioMed Central Ltd Critical Care 2008 12 127 doi cc6831 See related research by Vignon et al. http content 12 1 R18 Abstract The measurement of pulmonary artery occlusion pressure PAOP is important for estimation of left ventricular filling pressure and for distinction between cardiac and non-cardiac etiology of pulmonary edema. Clinical assessment of PAOP which relies on physical signs of pulmonary congestion is uncertain. Reliable PAOP measurement can be performed by pulmonary artery catheter but it is possible also by the use of echocardiography. Several Doppler variables show acceptable correlation with PAOP and can be used for its estimation in cardiac and critically ill patients. Noninvasive PAOP estimation should probably become an integral part of transthoracic and transesophageal echocardiographic evaluation in critically ill patients. However the limitations of both methods should be taken into consideration and in specific patients invasive PAOP measurement is still unavoidable if the exact value of PAOP is needed. Vignon and colleagues 1 prospectively assessed the ability of transesophageal echocardiography TEE to predict PAOP higher than 18 mmHg in mechanically ventilated patients with an inserted pulmonary artery catheter. In a first group they analyzed simple Doppler variables derived from transmitral flow TMF and pulmonary venous flow PVF and performed the usual measurements and calculations maximal velocity and velocity time integral of E the maximal velocity of early diastolic TMF and A the maximal velocity of late diastolic TMF wave E A ratio E

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