| Bedside assessment of mean systemic filling pressure. | |
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MedLine Citation:
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PMID: 20168223 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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PURPOSE OF REVIEW: The physiology of the venous part of the human circulation seems to be a forgotten component of the circulation in critical care medicine. One of the main reasons, probably, is that measures of right atrial pressure (Pra) do not seem to be directly linked to blood flow. This perception is primarily due to an inability to measure the pressure gradient for venous return. The upstream pressure for venous return is mean systemic filling pressure (Pmsf) and it does not lend itself easily to be measured. Recent clinical studies now demonstrate the basic principles underpinning the measure of Pmsf at the bedside. RECENT FINDINGS: Using routinely available minimally invasive monitoring of continuous cardiac output and Pra, one can accurately construct venous return curves by performing a series of end-inspiratory hold maneuvers, in ventilator-dependent patients. From these venous return curves, the clinician can now finally obtain at the bedside not only Pmsf but also the derived parameters: resistance to venous return, systemic compliance and stressed volume. SUMMARY: Measurement of Pmsf is essential to describe the control of vascular capacitance. It is the key to distinguish between passive and active mechanisms of blood volume redistribution and partitioning total blood volume in stressed and unstressed volume. |
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Authors:
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Jos R C Jansen; Jacinta J Maas; Michael R Pinsky |
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Publication Detail:
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Type: Journal Article; Review |
Journal Detail:
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Title: Current opinion in critical care Volume: 16 ISSN: 1531-7072 ISO Abbreviation: Curr Opin Crit Care Publication Date: 2010 Jun |
Date Detail:
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Created Date: 2010-05-13 Completed Date: 2010-08-13 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9504454 Medline TA: Curr Opin Crit Care Country: United States |
Other Details:
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Languages: eng Pagination: 231-6 Citation Subset: IM |
Affiliation:
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Department of Intensive Care Medicine, Leiden University Medical Center, The Netherlands. jrcjansen@lumc.nl <jrcjansen@lumc.nl> |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Blood Pressure Critical Care / methods* Hemodynamics* Humans Middle Aged Point-of-Care Systems* |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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