Document Detail


Tissue Doppler imaging estimation of pulmonary artery occlusion pressure in ICU patients.
MedLine Citation:
PMID:  14634723     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: Earlier reports suggested that transthoracic (TTE) determination of the ratio of mitral inflow E wave velocity to early diastolic mitral annulus velocity (E/E') measured by tissue Doppler imaging (TDI) closely approximates PAOP in cardiac patients. However, the value of E/E' for PAOP assessment in ICU patients has not been evaluated. This study assessed whether the E/E' ratio provides an accurate estimation of pulmonary artery occlusion pressure (PAOP) in mechanically ventilated ICU patients. DESIGN AND SETTING: Prospective, open, clinical study in the ICU of a university hospital. PATIENTS: Twenty-three consecutive mechanically ventilated patients. INTERVENTIONS: Volume expansion in 14 patients. MEASUREMENTS AND RESULTS: Doppler TTE or TEE mitral inflow and TDI mitral annulus velocities were determined and compared with PAOP measured using a Swan-Ganz catheter. Of all the Doppler variables studied the best correlations were observed between PAOP and the lateral (r=0.84) and medial (r=0.76) annulus E/E' ratio and remained highly significant when the analysis was restricted to TEE (r=0.91 and 0.86) or TTE (r=0.73 and 0.61). The sensitivities and specificities of estimating PAOP at 15 mmHg or higher were, respectively, 86% and 81% for lateral E/E' above 7.5 and 76% and 80% for medial E/E' above 9. PAOP changes after volume expansion (700+/-230 ml) were limited and accurately assessed by repeated E/E' determinations. CONCLUSIONS: In mechanically ventilated ICU patients TTE or TEE E/E' determinations using TDI closely approximate PAOP.
Authors:
Alain Combes; Florence Arnoult; Jean-Louis Trouillet
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Publication Detail:
Type:  Comparative Study; Journal Article; Validation Studies     Date:  2003-11-21
Journal Detail:
Title:  Intensive care medicine     Volume:  30     ISSN:  0342-4642     ISO Abbreviation:  Intensive Care Med     Publication Date:  2004 Jan 
Date Detail:
Created Date:  2004-01-12     Completed Date:  2004-03-26     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7704851     Medline TA:  Intensive Care Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  75-81     Citation Subset:  IM    
Affiliation:
Réanimation Médicale,Institut de Cardiologie, AP-HP, Hôpital Pitié-Salpêtrière, 47 Boulevard de l'Hôpital, 75013 Paris, France. alain.combes@psl.ap-hop-paris.fr
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MeSH Terms
Descriptor/Qualifier:
Adult
Aged
Blood Flow Velocity
Critical Care / methods,  standards
Echocardiography / methods,  standards*
Echocardiography, Doppler / methods,  standards*
Echocardiography, Transesophageal / methods,  standards*
Feasibility Studies
Female
Hospitals, University
Humans
Linear Models
Male
Middle Aged
Mitral Valve / ultrasonography*
Observer Variation
Prospective Studies
Pulmonary Wedge Pressure*
Respiration, Artificial
Sensitivity and Specificity
Single-Blind Method

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


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