Intensive Care Med (2017) 43:1438–1439 DOI 10.1007/s00134-017-4836-7 CORRESPONDENCE The dynamic arterial elastance: a call for a cautious interpretation Discussion on “Predicting vasopressor needs using dynamic parameters” 1,2 1,2 1,2* 3 4 Mathieu Jozwiak , Xavier Monnet , Jean‑Louis Teboul , M. Ignacio Monge García , Michael R. Pinsky and Maurizio Cecconi © 2017 Springer‑ Verlag Berlin Heidelberg and ESICM value would discourage clinicians from infusing fluids, Initial correspondence from Drs. Jozwiak, with inherent risks of under-resuscitation. It should be Monnet and Teboul more clearly stated that a low Ea should not contrain- dyn Dear Editor, dicate administration of fluids in preload-responsive We read with great interest the article by Monge García patients but rather should suggest initiation of vasopres- et al.  that emphasizes the ability of dynamic arterial sors in combination with fluid infusion. elastance (Ea ), defined as the pulse pressure variation dyn (PPV)/stroke volume variation (SVV) ratio, to predict the Reply from Drs. Monge García, Pinsky and Cecconi mean arterial pressure (MAP) response to volume expan- We thank Drs. Jozwiak, Monnet and Teboul for their val- sion in preload-responsive patients. uable comments on our editorial “Predicting vasopressor However, we want to point out two issues, which should needs using dynamic parameters”
Intensive Care Medicine – Springer Journals
Published: May 11, 2017
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