Document Detail

Left ventricular end-diastolic area is a measure of cardiac preload in patients with early septic shock.
MedLine Citation:
PMID:  19390446     Owner:  NLM     Status:  MEDLINE    
BACKGROUND AND OBJECTIVE: Central venous pressure, intrathoracic blood volume, and left ventricular end-diastolic area are reliable measures of cardiac preload under stable clinical conditions. The purpose of this study was to compare different preload parameters over 24 h under conditions of multiple, frequently changing treatments in early septic shock. METHODS: In 28 mechanically ventilated patients within 6 h of the onset of septic shock, left ventricular end-diastolic area was measured using transoesophageal echocardiography. Intrathoracic blood volume, stroke volume variation, and central venous pressure were analysed as preload parameters. The relation between parameter changes and changes in therapy was examined with respect to cardiac index and stroke volume index. RESULTS: Regarding preload variables, linear regression analyses revealed a significant correlation between left ventricular end-diastolic area and stroke volume index (r=0.59, P<0.001) and cardiac index (r=0.41, P<0.001), respectively. Changes in left ventricular end-diastolic index and intrathoracic blood volume index reflected changes in the stroke volume index, whereas central venous pressure did not. Myocardial responsiveness also failed to predict changes in the stroke volume index. CONCLUSION: Only the left ventricular end-diastolic area index may help predict preload in ventilated patients with early septic shock.
Karoline Scheuren; Moritz N Wente; Christian Hainer; Matthias Scheffler; Christoph Lichtenstern; Eike Martin; Jan Schmidt; Christian Bopp; Markus A Weigand
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  26     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2009 Sep 
Date Detail:
Created Date:  2009-08-20     Completed Date:  2010-01-11     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  759-65     Citation Subset:  IM    
Department of Anaesthesiology, University of Heidelberg, Heidelberg, Germany.
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MeSH Terms
Cardiac Output / physiology*
Central Venous Pressure / physiology
Echocardiography, Transesophageal
Middle Aged
Myocardial Contraction
Regression Analysis
Respiration, Artificial
Shock, Septic / physiopathology*,  therapy
Stroke Volume / physiology
Treatment Outcome
Ventricular Function, Left / physiology*

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