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D. Reuter, Julian Bayerlein, M. Goepfert, F. Weis, E. Kilger, P. Lamm, A. Goetz (2003)
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Prediction of fluid responsiveness: searching for the Holy Grail The following is the abstract of the article discussed in the subsequent letter: The accuracy and clinical utility of preload indexes as bedside indicators of fluid responsiveness in patients after cardiac surgery is controversial. This study evaluates whether respiratory changes (Δ) in the preejection period (PEP; ΔPEP) predict fluid responsiveness in mechanically ventilated patients. Sixteen postcoronary artery bypass surgery patients, deeply sedated under mechanical ventilation, were enrolled. PEP was defined as the time interval between the beginning of the Q wave on the electrocardiogram and the upstroke of the radial arterial pressure. ΔPEP (%) was defined as the difference between expiratory and inspiratory PEP measured over one respiratory cycle. We also measured cardiac output, stroke volume index, right atrial pressure, pulmonary arterial occlusion pressure, respiratory change in pulse pressure, systolic pressure variation, and the Δdown component of SPV. Data were measured without positive end-expiratory pressure (PEEP) and after application of a PEEP of 10 cmH 2 O (PEEP 10 ). When PEEP 10 induced a decrease of >15% in mean arterial pressure value, then measurements were re-performed before and after volume expansion. Volume loading was done in eight patients.
Journal of Applied Physiology – The American Physiological Society
Published: Aug 1, 2004
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