Assessing fluid responsiveness in critically ill patients: False-positive pulse pressure variation is detected by Doppler echocardiographic evaluation of the right ventricle*
| العنوان: | Assessing fluid responsiveness in critically ill patients: False-positive pulse pressure variation is detected by Doppler echocardiographic evaluation of the right ventricle* |
|---|---|
| المؤلفون: | Claude Galy, Michel Slama, Yazine Mahjoub, Arnaud Friggeri, Elie Zogheib, Cyrille Pila, Hervé Dupont, Eric Lobjoie, François Tinturier |
| المصدر: | Critical Care Medicine. 37:2570-2575 |
| بيانات النشر: | Ovid Technologies (Wolters Kluwer Health), 2009. |
| سنة النشر: | 2009 |
| مصطلحات موضوعية: | Male, medicine.medical_specialty, Systole, Critical Illness, Positive pressure, Critical Care and Intensive Care Medicine, symbols.namesake, Tissue Doppler echocardiography, Intensive care, Internal medicine, medicine, Humans, False Positive Reactions, Prospective Studies, cardiovascular diseases, Pulse, Aged, Pulse (signal processing), business.industry, Middle Aged, Echocardiography, Doppler, Pulse pressure, medicine.anatomical_structure, Ventricle, Anesthesia, Ventricular Function, Right, cardiovascular system, Cardiology, symbols, Fluid Therapy, Female, business, Doppler effect |
| الوصف: | To determine whether peak systolic velocity of tricuspid annular motion assessed by tissue Doppler echocardiography (Sta), a right ventricular function parameter, can discriminate patients with true- and false-positive pulse pressure variation. Pulse pressure variation is used to predict fluid responsiveness in mechanically ventilated patients. However, this parameter has been reported to be falsely positive, especially in patients with right ventricular dysfunction.A prospective study.Medical and surgical intensive care unit of a university hospital.Thirty- five mechanically ventilated patients hospitalized for24 hrs with a pulse pressure variation of12%.Doppler echocardiography (including measurement of Sta and stroke volume) was performed before and after infusion of 500 mL of colloid solution. Patients were classified into two groups according to their response to fluid infusion: responders (at least 15% increase in stroke volume) and nonresponders.Twenty-three patients (66%) were responders (true-positive group) and 12 (34%) were nonresponders (false-positive group). Before volume expansion, Sta was statistically lower in the nonresponder group (0.13 [0.04] vs. 0.20 [0.05], p = .0004). The area under the curve of the receiver operating characteristic curve was 0.87 (95% confidence interval, 0.74-1). In patients with pulse pressure variation of12%, a Sta cutoff value of 0.15 m/s discriminated between responders and nonresponders with a sensitivity of 91% (80-100) and a specificity of 83% (62-100).A Sta value of0.15 m/s seems to be an accurate parameter to detect false-positive pulse pressure variation. Echocardiography should therefore be performed before fluid infusion in patients with pulse pressure variation of12%. |
| تدمد: | 0090-3493 |
| DOI: | 10.1097/ccm.0b013e3181a380a3 |
| URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::c49d21db76df0f2acc59c6187c5b6123 https://doi.org/10.1097/ccm.0b013e3181a380a3 |
| رقم الانضمام: | edsair.doi.dedup.....c49d21db76df0f2acc59c6187c5b6123 |
| قاعدة البيانات: | OpenAIRE |
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