Document Detail


Military antishock trouser (MAST). Application as a reversible fluid challenge in patients on high PEEP.
MedLine Citation:
PMID:  6370618     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Fluid management in the critically ill patient receiving high levels of positive end-expiratory pressure (PEEP) can be difficult. PEEP may cause the cardiac index to fall due to a decrease in left ventricular preload. However, the high intrathoracic pressures produced by PEEP negate the usefulness of the pulmonary artery occlusion pressure (PAo) as a measurement of left ventricular preload. The military antishock trouser (MAST), which has been presumed to compress the venous capacitance reservoir and auto-transfuse 500 to 1,000 ml to the central circulation, was used as a reversible predictor of the effects of fluids on 12 critically ill patients receiving PEEP greater than 10 cm H2O with a decreased cardiac index. Hemodynamic variables were measured before, during, and after MAST inflation. Fluids were given in a quantity sufficient to maintain the same PAo after MAST deflation as achieved with the initial inflation. A significant improvement of cardiac performance and a high correlation between MAST and post-MAST variables was observed. Application of MAST as a reversible fluid challenge is a useful method for predicting optimal fluid management.
Authors:
M S Jastremski; K M Beney
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Chest     Volume:  85     ISSN:  0012-3692     ISO Abbreviation:  Chest     Publication Date:  1984 May 
Date Detail:
Created Date:  1984-06-06     Completed Date:  1984-06-06     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0231335     Medline TA:  Chest     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  595-9     Citation Subset:  AIM; IM; S    
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Critical Care
Dobutamine / therapeutic use
Dopamine / therapeutic use
Female
Fluid Therapy*
Gravity Suits*
Heart / physiopathology
Hemodynamics
Humans
Male
Middle Aged
Positive-Pressure Respiration* / adverse effects
Respiratory Distress Syndrome, Adult / physiopathology,  therapy*
Chemical
Reg. No./Substance:
34368-04-2/Dobutamine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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