Mao-lei Gong1, Da-wei Liu, Xiao-ting Wang, Xiu-kai Chen. 1. Department of Critical Care Medicine, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing 100730, China.
Abstract
OBJECTIVE: To explore the value of dynamic arterial elastance (Eadyn) in the predication of arterial pressure response to volume loading in shock patients. METHODS: A total of 32 patients with pulse indicator continuous cardiac output (PICCO) monitoring at our intensive care unit from January 2011 to December 2012 were retrospectively studied. The decision of fluid replacement was based upon the presence of shock (mean arterial pressure (MAP) ≤ 65 mm Hg, systolic arterial pressure <90 mm Hg or a decrease of 40 mm Hg from baseline) and preserved volume responsiveness condition with a stroke volume variation (SVV) value ≥ 10%. According to the MAP increase after volume loading, they were classified into MAP responders (≥ 15%) and MAP nonresponders (<15%) respectively. The goal was to investigate the influencing factors of the changes of MAP after volume loading and predict the arterial pressure response to volume loading. RESULTS: Significantly different between MAP responders and MAP nonresponders, baseline Eadyn was an effective predictor of MAP increase after volume loading. The area under the ROC curve was 0.95 for the prediction of volume loading on MAP for Eadyn at baseline (P < 0.01). A baseline Eadyn value >0.85 predicted a MAP increase after volume administration with a sensitivity of 89.5% and a specificity of 92.3%. CONCLUSION: Baseline Eadyn may predict accurately arterial pressure response in MAP to volume loading in shock patients.
OBJECTIVE: To explore the value of dynamic arterial elastance (Eadyn) in the predication of arterial pressure response to volume loading in shockpatients. METHODS: A total of 32 patients with pulse indicator continuous cardiac output (PICCO) monitoring at our intensive care unit from January 2011 to December 2012 were retrospectively studied. The decision of fluid replacement was based upon the presence of shock (mean arterial pressure (MAP) ≤ 65 mm Hg, systolic arterial pressure <90 mm Hg or a decrease of 40 mm Hg from baseline) and preserved volume responsiveness condition with a stroke volume variation (SVV) value ≥ 10%. According to the MAP increase after volume loading, they were classified into MAP responders (≥ 15%) and MAP nonresponders (<15%) respectively. The goal was to investigate the influencing factors of the changes of MAP after volume loading and predict the arterial pressure response to volume loading. RESULTS: Significantly different between MAP responders and MAP nonresponders, baseline Eadyn was an effective predictor of MAP increase after volume loading. The area under the ROC curve was 0.95 for the prediction of volume loading on MAP for Eadyn at baseline (P < 0.01). A baseline Eadyn value >0.85 predicted a MAP increase after volume administration with a sensitivity of 89.5% and a specificity of 92.3%. CONCLUSION: Baseline Eadyn may predict accurately arterial pressure response in MAP to volume loading in shockpatients.