Evaluation of Left Ventricular Function in Anesthetized Patients Using Femoral Artery dP/dtmax

Hert, Stefan De; Robert, Dominique; Cromheecke, S.; Michard, Frédèric; Nijs, Jan; Rodrigus, Inez

doi:10.1053/j.jvca.2005.11.006

Cited by 54 publications

(50 citation statements)

References 15 publications

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“…It also tracks changes in inotropic state accurately in adults [47]. A limitation of this measure is its sensitivity to changes in preload [47]. However, this potential collinearity did not appear to be significant in our study, given the low regression variance inflation factors (Table 3).…”

Section: Study Limitationsmentioning

confidence: 65%

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Predicting fluid responsiveness in 100 critically ill children: the effect of baseline contractility

et al. 2015

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Section: Study Limitationsmentioning

confidence: 65%

“…Also, the PRAM estimate of dp/dt MAX appears valid (despite being inaccurate for SVI) when compared to echocardiographically derived dp/dt MAX in adults [46]. It also tracks changes in inotropic state accurately in adults [47]. A limitation of this measure is its sensitivity to changes in preload [47].…”

Section: Study Limitationsmentioning

confidence: 93%

Predicting fluid responsiveness in 100 critically ill children: the effect of baseline contractility

et al. 2015

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“…[27–29] In adults undergoing coronary artery bypass surgery, femoral dP/dt max obtained from arterial waveform analysis using the transpulmonary thermodilution monitor (PiCCOplus; Pulsion, Munich, Germany) has shown to be closely related to LV dP/dt max during inotropic administration. [30] Although disappointing results have been reported following application of these noninvasive hemodynamic monitoring for neonates and small children, [31–33] evidence has been growing to show the applicability of dP/dt max . Recently, it has been suggested that the dP/dt max , which is provided using a device embedded arterial pulse contour analysis (Mostcare/PRAM; Vytech, Padova, Italy) can be used as an index of ventricular contractility.…”

Section: Discussionmentioning

confidence: 99%

Usefulness of the maximum rate of pressure rise in the central and peripheral arteries after weaning from cardiopulmonary bypass in pediatric congenital heart surgery

et al. 2016

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The maximum rate of pressure rise (dP/dtmax) in radial artery has been proposed as a noninvasive surrogate of aortic dp/dtmax, reflecting left ventricular (LV) contractility in children. The aim of this study was to investigate relationship between aortic and radial dp/dtmax at weaning from cardiopulmonary bypass (CPB) and usefulness of these indices for estimating postoperative outcomes in pediatric congenital heart surgery.Aortic and radial arterial pressure waveforms were analyzed simultaneously during weaning from CPB in 29 congenital heart surgery. The maximum first derivatives of aortic and radial arterial waveforms were calculated and averaged from 3 consecutive respiratory cycles. We obtained the maximum vasoactive inotropic score during the first 36 postoperative hours, LV ejection fraction, and fractional shortening on transthoracic echocardiography performed within postoperative day 7.A significant difference between aortic and radial dP/dtmax was observed (mean difference 356 mm Hg/s, 44% of averages), and radial dP/dtmax was weakly correlated with aortic dP/dtmax (r =0.373, P = 0.047). Aortic dP/dtmax was significantly associated with the maximum vasoactive inotropic score (P < 0.001), postoperative LV ejection fraction (P = 0.018), and fractional shortening (P = 0.015); however, radial dP/dtmax was not. On Receiver operating characteristic analysis, aortic dP/dtmax had a greater area under the curve than radial dP/dtmax in predicting higher vasoactive inotropic score (0.827 vs 0.673).Immediately after CPB in pediatric congenital heart surgery, radial dP/dtmax may not replace aortic dP/dtmax because of a discrepancy between central and peripheral arterial waveforms. In this critical period, aortic dP/dtmax can be useful to estimate postoperative ventricular function rather than peripherally derived dP/dtmax.

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“…Evaluating maximum aortic dp/dt is clinically helpful for the management of aortic dissections (Carney et al 1975;Prokop et al 1970) and may be a useful cardiac index as well (Schertel 1998;De Hert et al 2006). Also, maximum aortic dp/dt can be determined using the product of blood density, aortic pulse wave velocity, and the maximum acceleration of aortic blood flow (Atlas 2002) (See ''Pulse Wave Velocity, Characteristic Volume and Aortic Characteristic Impedance'' section).…”

Section: Application Of the Logistic-based Systolic Modelmentioning

confidence: 99%

Development and Application of a Logistic-Based Systolic Model for Hemodynamic Measurements Using the Esophageal Doppler Monitor

Atlas

2008

Cardiovasc Eng

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The esophageal Doppler monitor (EDM) is a clinically useful device for minimally invasive assessment of cardiac output, preload, afterload, and contractility. An empirical model, based upon the logistic function, has been developed. Use of this model illustrates how the EDM could estimate the net effect of aortic and non-aortic contributions to inertia, resistance, and elastance within real time. This is based on an assumed mechanical impedance conceptually resembling that of a series arrangement of a spring, mass, and dashpot. In addition, when used with an invasive radial arterial catheter, the EDM may also estimate aortic pulse wave velocity, as well as aortic characteristic impedance, and characteristic volume. Approximations of left ventricular stroke work and stroke power can also be made. Furthermore, the effects of inertia, resistance, and elastance, on mean blood pressure during systole, can be quantified. These additional parameters could offer insight for clinicians, as well as researchers, and may be beneficial in further examining and utilizing clinical hemodynamics with the EDM. These additional measurements also underscore the need to integrate the EDM with existing and future monitoring equipment.

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Evaluation of Left Ventricular Function in Anesthetized Patients Using Femoral Artery dP/dtmax

Cited by 54 publications

References 15 publications

Predicting fluid responsiveness in 100 critically ill children: the effect of baseline contractility

Predicting fluid responsiveness in 100 critically ill children: the effect of baseline contractility

Usefulness of the maximum rate of pressure rise in the central and peripheral arteries after weaning from cardiopulmonary bypass in pediatric congenital heart surgery

Development and Application of a Logistic-Based Systolic Model for Hemodynamic Measurements Using the Esophageal Doppler Monitor

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