Hemorrhagic Shock in Polytrauma Patients: Early Detection with Renal Doppler Resistive Index Measurements

Corradi, Francesco; Brusasco, Claudia; Vezzani, Antonella; Palermo, Salvatore; Altomonte, F; Moscatelli, P; Pelosi, Paolo

doi:10.1148/radiol.11102338

Cited by 61 publications

(43 citation statements)

References 42 publications

(33 reference statements)

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“…There is a general consensus about a cutoff range of RRI 0.70÷0.74 to define patients exposed to a significant risk of AKI or other adverse events after major surgery (10,11). In our sample the median value was a little lower (RRI 0.68) than the cutoff.…”

Section: Discussionmentioning

confidence: 76%

Renal Resistive Index: A Tool for Postoperative Intensive Care Unit-Outcome? A Pilot Observational Study

Giustiniano

Ruggieri

Meco

2015

JACCOA

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Section: Discussionmentioning

confidence: 76%

Renal Resistive Index: A Tool for Postoperative Intensive Care Unit-Outcome? A Pilot Observational Study

Giustiniano

Ruggieri

Meco

2015

JACCOA

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“…Several studies have shown the usefulness of RRI to predict the occurrence and severity of AKI in critically ill patients. Corradi et al showed that the RRI is altered in patients with haemorrhagic shock [36], while in critically ill patients it has been shown to be clinically useful in order to predict the reversibility of AKI [37]. An improvement of RRI has also been demonstrated after an increase of MAP with noradrenaline in septic shock patients [38].…”

Section: Rri = Peak Systolic Velocity -End Diastolic Velocity Peak Symentioning

confidence: 99%

From cardiac output to blood flow auto-regulation in shock

Aya

Bazurro

Bastoni

et al. 2015

Anaesthesiol Intensive Ther

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Shock is defined as a state in which the circulation is unable to deliver sufficient oxygen to meet the demands of the tissues, resulting in cellular dysoxia and organ failure. In this process, the factors that govern the circulation at a haemodynamic level and oxygen delivery at a microcirculatory level play a major role. This manuscript aims to review the blood flow regulation from macro-and micro-haemodynamic point of view and to discuss new potential therapeutic approaches for cardiovascular instability in patients in cardiovascular shock. Despite the recent advances in haemodynamics, the mechanisms that control the vascular resistance and the venous return are not fully understood in critically ill patients. The physical properties of the vascular wall, as well as the role of the mean systemic filling pressure are topics that require further research. However, the haemodynamics do not totally explain the physiopathology of cellular dysoxia, and several factors such as inflammatory changes at the microcirculatory level can modify vascular resistance and tissue perfusion. Cellular vasoactive mediators and endothelial and glucocalix damage are also involved in microcirculatory impairment. All the levels of the circulatory system must be taken into account. Evaluation of microcirculation may help one to detect under-diagnosed shock, and together with classic haemodynamics, guide one towards the appropriate therapy. Restoration of classic haemodynamic parameters is essential but not sufficient to detect and treat patients in cardiovascular shock.

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“…The use of such modalities as the renal or splenic Doppler resistance index in trauma is promising for identifying those patients at the bedside, but these modalities will need further confirmation in critically ill patients. 39,40 Dynamic variables are most useful in finding the patient's individual point on the Frank-Starling curve.…”

Section: Dynamic Variablesmentioning

confidence: 99%