Applying mean systemic filling pressure to assess the response to fluid boluses in cardiac post-surgical patients

Gupta, Kapil; Søndergaard, Søren; Parkin, Geoffrey; Leaning, M.S.; Åneman, Anders

doi:10.1007/s00134-014-3611-2

Cited by 43 publications

(49 citation statements)

References 23 publications

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“…Following approval of the local Human Research Ethics Committee (LNR/15/LPOOL/47, approved 14th April 2015), 35 patients were enrolled in this prospective, observational study. A sample size of 30 patients was calculated to ensure that the change in CO following PLR as determined by pulmonary artery thermodilution could be estimated by a similar change ± 10% in CCA Dflow with a 95% confidence interval, using previous variance data from a similar cohort . Furthermore, 29 patients would be needed to ascertain a correlation coefficient r = 0.5 with a type I error of 0.05 and a type II error of 0.2.…”

Section: Methodsmentioning

confidence: 99%

Carotid Doppler flowmetry correlates poorly with thermodilution cardiac output following cardiac surgery

Roehrig

Govier

Robinson

et al. 2016

Acta Anaesthesiol Scand

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Section: Methodsmentioning

confidence: 99%

Carotid Doppler flowmetry correlates poorly with thermodilution cardiac output following cardiac surgery

Roehrig

Govier

Robinson

et al. 2016

Acta Anaesthesiol Scand

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“…and Gupta et al. showing an E vol of 0.36 and 0.32 in the volume responding group vs. 0.07 and 0.03 in the non‐responding group …”

Section: Resultsmentioning

confidence: 87%

Central venous pressure: we need to bring clinical use into physiological context

Søndergaard

Parkin

Åneman

2015

Acta Anaesthesiol Scand

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“…The gold standard for assessing fluid responsiveness is defined as a change in the cardiac output or stroke volume ≥10–15% after a rapid 250 ml volume infusion [16]. However, as a simple, safe and reversible method that could promote venous blood move from the legs and splanchnic compartment to the thorax, the PLR is now used to accurately predict fluid responsiveness in most conditions [17–19].…”

Section: Discussionmentioning

confidence: 99%

Fluid responsiveness predicted by transcutaneous partial pressure of oxygen in patients with circulatory failure: a prospective study

Xiao

Pan

et al. 2017

Ann. Intensive Care

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Background: Significant effort has been devoted to defining parameters for predicting fluid responsiveness. Our goal was to study the feasibility of predicting fluid responsiveness by transcutaneous partial pressure of oxygen (PtcO 2 ) in the critically ill patients. Methods:This was a single-center prospective study conducted in the intensive care unit of a tertiary care teaching hospital. Shock patients who presented with at least one clinical sign of inadequate tissue perfusion, defined as systolic blood pressure <90 mmHg or a decrease >40 mmHg in previously hypertensive patients or the need for vasopressive drugs; urine output <0.5 ml/kg/h for 2 h; tachycardia; lactate >4 mmol/l, for less than 24 h in the absence of a contraindication for fluids were eligible to participate in the study. PtcO 2 was continuously recorded before and during a passive leg raising (PLR) test, and then before and after a 250 ml rapid saline infusion in 10 min. Fluid responsiveness is defined as a change in the stroke volume ≥10% after 250 ml of volume infusion. Results:Thirty-four patients were included, and 14 responded to volume expansion. In the responders, the mean arterial pressure, central venous pressure, cardiac output, stroke volume and PtcO 2 increased significantly, while the heart rate decreased significantly by both PLR and volume expansion. Changes in the stroke volume induced either by PLR or volume expansion were significantly greater in responders than in non-responders. The correlation between the changes in PtcO 2 and stroke volume induced by volume expansion was significant. Volume expansion induced an increase in the PtcO 2 of 14% and PLR induced an increase in PtcO 2 of 13% predicted fluid responsiveness. Conclusions:This study suggested the changes in PtcO 2 induced by volume expansion and a PLR test predicted fluid responsiveness in critically ill patients.Trial registration NCT02083757.

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Applying mean systemic filling pressure to assess the response to fluid boluses in cardiac post-surgical patients

Abstract: Using an algorithm to derive a mean systemic filling pressure analogue, cardiac power and dynamic measures of the venous return pressure gradient relative to the mean systemic filling pressure provided an assessment of the efficiency of volume expansion in post-surgical cardiac patients.

Cited by 43 publications

References 23 publications

Carotid Doppler flowmetry correlates poorly with thermodilution cardiac output following cardiac surgery

Carotid Doppler flowmetry correlates poorly with thermodilution cardiac output following cardiac surgery

Central venous pressure: we need to bring clinical use into physiological context

Fluid responsiveness predicted by transcutaneous partial pressure of oxygen in patients with circulatory failure: a prospective study

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