Reference : Arterial dP/dtmax accurately reflects left ventricular contractility during shock whe...
Scientific journals : Article
Human health sciences : Anesthesia & intensive care
Arterial dP/dtmax accurately reflects left ventricular contractility during shock when adequate vascular filling is achieved
MORIMONT, Philippe mailto [Centre Hospitalier Universitaire de Liège - CHU > > Frais communs médecine >]
LAMBERMONT, Bernard mailto [Centre Hospitalier Universitaire de Liège - CHU > > Frais communs médecine >]
Desaive, Thomas mailto [Université de Liège - ULiège > Département d'astrophys., géophysique et océanographie (AGO) > Thermodynamique des phénomènes irréversibles >]
JANSSEN, Nathalie mailto [Centre Hospitalier Universitaire de Liège - CHU > > Urgences >]
Chase, J. Geoffrey [Mechanical Engineering Department, University of Canterbury, Christchurch, New Zealand]
D'Orio, Vincenzo mailto [Université de Liège - ULiège > Département des sciences cliniques > Médecine d'urgence - bioch. et phys. hum. normales et path. >]
BMC Cardiovascular Disorders
BioMed Central
Yes (verified by ORBi)
[en] Aortic pressure ; Endotoxin-induced shock ; Left ventricular function ; Preload responsiveness ; Septic cardiomyopathy
[en] Background: Peak first derivative of femoral artery pressure (arterial dP/dt
max) derived from fluid-filled catheter remains questionable to assess left ventricular (LV) contractility during shock. The aim of this study was to test if arterial dP/dt
maxis reliable for assessing LV contractility during various hemodynamic conditions such as endotoxin-induced shock and catecholamine infusion.Methods: Ventricular pressure-volume data obtained with a conductance catheter and invasive arterial pressure obtained with a fluid-filled catheter were continuously recorded in 6 anaesthetized and mechanically ventilated pigs. After a stabilization period, endotoxin was infused to induce shock. Catecholamines were transiently administrated during shock. Arterial dP/dt
maxwas compared to end-systolic elastance (Ees), the gold standard method for assessing LV contractility.Results: Endotoxin-induced shock and catecholamine infusion lead to significant variations in LV contractility. Overall, significant correlation (r = 0.51; p < 0.001) but low agreement between the two methods were observed. However, a far better correlation with a good agreement were observed when positive-pressure ventilation induced an arterial pulse pressure variation (PPV) ≤ 11% (r = 0.77; p < 0.001).Conclusion: While arterial dP/dt
maxand Ees were significantly correlated during various hemodynamic conditions, arterial dP/dt
maxwas more accurate for assessing LV contractility when adequate vascular filling, defined as PPV ≤ 11%, was achieved. © 2012 Morimont et al; licensee BioMed Central Ltd.

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