Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge
Cardiac filling pressures are not appropriate to predict hemodynamic response to volume challenge
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DOI：
10.1097/01.ccm.0000249851.94101.4f
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发表时间：
2007-01-01
影响因子：
8.8
通讯作者：
Teboul, Jean-Louis
中科院分区：
文献类型：
--
作者：
Osman, David;Ridel, Christophe;Teboul, Jean-Louis
目标。在最近的国际严重脓毒症管理指南中，中心静脉压8- 12mmhg和肺动脉闭塞压12- 15mmhg被提议作为容量复苏目标。通过分析大量的容量挑战，我们的目的是测试推荐的目标值在预测容量响应性方面的重要性。回顾study.Setting。有24张病床的重症监护室病人2001年至2004年间，所有连续接受肺动脉导管监测的脓毒症患者均接受容积挑战。干预:没有。测量和主要结果。我们回顾了96例患者的150例体积挑战。在65例中，容量挑战导致心脏指数增加>= 15%（应答者）。有反应者和无反应者的输液前中心静脉压相似（8 +/- 4 vs 9 +/- 4 mmhg）。反应者输注前肺动脉闭塞压略低(10 +/- 4 vs. 11 +/- 4 mm Hg, p
Objective. Values of central venous pressure of 8-12 mm Hg and of pulmonary artery occlusion pressure of 12-15 mm Hg have been proposed as volume resuscitation targets in recent international guidelines on management of severe sepsis. By analyzing a large number of volume challenges, our aim was to test the significance of the recommended target values in terms of prediction of volume responsiveness.Design. Retrospective study.Setting., A 24-bed medical intensive care unit.Patients., All consecutive septic patients monitored with a pulmonary artery catheter who underwent a volume challenge between 2001 and 2004.Intervention: None.Measurements and Main Results. A total of 150 volume challenges in 96 patients were reviewed. In 65 instances, the volume challenge resulted in an increase in cardiac index of >= 15% (responders). The pre-infusion central venous pressure was similar in responders and nonresponders (8 +/- 4 vs. 9 +/- 4 mm Hg). The pre-infusion pulmonary artery occlusion pressure was slightly lower in responders (10 +/- 4 vs. 11 +/- 4 mm Hg, p