| Evaluation of mean systemic filling pressure from pulse contour cardiac output and central venous pressure. | |
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MedLine Citation:
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PMID: 21830048 Owner: NLM Status: Publisher |
Abstract/OtherAbstract:
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OBJECTIVE: The volemic status of a patient can be determined by measuring mean systemic filling pressure (Pmsf). Pmsf is obtained from the venous return curve, i.e. the relationship between central venous pressure (Pcv) and blood flow. We evaluated the feasibility and precision of Pmsf measurement. METHODS: In ten piglets we constructed venous return curves using seven 12 s inspiratory holds transiently increasing Pcv to seven different steady state levels and monitored the resultant blood flow, by pulse contour (COpc) and by flow probes around the pulmonary artery (COr) and aorta (COl). Pmsf is obtained by extrapolation of the venous return curve to zero flow. Measurements were repeated to evaluate the precision of Pmsf. RESULTS: During the inspiratory holds, 133 paired data points were obtained for COr, COl, COpc and Pcv. Bland-Altman analysis showed no difference between COr and COl, but a small significant difference was present between COl and COpc. All Pcv versus flow (COl or COpc) relationships were linear. Mean Pmsf was 10.78 with COl and 10.37 mmHg with COpc. Bland-Altman analysis for Pmsf with COl and with COpc, showed a bias of 0.40 ± 0.48 mmHg. The averaged coefficient of variation for repeated measurement of Pmsf with COl was 6.2% and with COpc 6.1%. CONCLUSIONS: During an inspiratory hold pulmonary flow and aortic flow equilibrate. Cardiac output estimates by arterial pulse contour and by a flow probe around the aorta are interchangeable. Therefore, the venous return curve and Pmsf can be estimated accurately by pulse contour methods. |
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Authors:
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Jacinta J Maas; Bart F Geerts; Jos R C Jansen |
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Publication Detail:
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Type: JOURNAL ARTICLE Date: 2011-8-10 |
Journal Detail:
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Title: Journal of clinical monitoring and computing Volume: - ISSN: 1573-2614 ISO Abbreviation: - Publication Date: 2011 Aug |
Date Detail:
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Created Date: 2011-8-10 Completed Date: - Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9806357 Medline TA: J Clin Monit Comput Country: - |
Other Details:
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Languages: ENG Pagination: - Citation Subset: - |
Affiliation:
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Department of Intensive Care, H4Q, Leiden University Medical Center, P.O. Box 9600, 2300 RC, Leiden, The Netherlands, j.j.maas@lumc.nl. |
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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