Affordable Access

Access to the full text

Fluid expansion improve ventriculo-arterial coupling in preload-dependent patients: a prospective observational study

Authors
  • Huette, Pierre1
  • Abou-Arab, Osama1
  • Longrois, Dan2
  • Guinot, Pierre-Grégoire3
  • 1 Amiens University Hospital, Rond point Fernand Leger, Amiens, F-80054, France , Amiens (France)
  • 2 Bichat Claude Bernard Hospital and INSERM1148, Paris, France , Paris (France)
  • 3 Dijon University Hospital, 2 Bd Maréchal de Lattre de Tassigny, Dijon, F-21000, France , Dijon (France)
Type
Published Article
Journal
BMC Anesthesiology
Publisher
Springer (Biomed Central Ltd.)
Publication Date
Jul 17, 2020
Volume
20
Issue
1
Identifiers
DOI: 10.1186/s12871-020-01087-7
Source
Springer Nature
Keywords
License
Green

Abstract

BackgroundThe objectives of the present study was to evaluate the effect of fluid challenge (FC) on ventriculo-arterial (V-A) coupling, its determinants: arterial elastance and ventricular elastance, and ability to predict fluid responsiveness.MethodsThirty patients admitted to cardio-thoracic ICU in whom the physician decided to perform FC were included. Arterial pressure, cardiac output, arterial elastance, and ventricular elastance, were measured before and after FC with 500 ml of lactated Ringer’s solution. Fluid responders were defined as patients with more than a 15% increase in stroke volume. V-A coupling was evaluated by the arterial elastance to ventricular elastance ratio.ResultsTwenty-three (77%) of the 30 patients included in the study were fluid responders. Before FC, responders had higher arterial elastance and arterial elastance to ventricular elastance ratio. FC significantly increased mean arterial pressure, stroke volume and cardiac output, and significantly decreased systemic vascular resistance, arterial elastance and consequently the arterial elastance to ventricular elastance ratio. Changes in arterial elastance were correlated with changes in stroke volume, systemic vascular resistance, and arterial compliance. Baseline arterial elastance to ventricular elastance ratio over 1.4 predicted fluid responsiveness (area under the curve [95% confidence interval]: 0.84 [0.66–1]; p < 0.0001).ConclusionsFluid responsiveness patients had V-A coupling characterized by increase arterial elastance to ventricular elastance ratio, in relation to an increase arterial elastance. Fc improved the V-A coupling ratio by decreasing arterial elastance without altering ventricular elastance. Arterial elastance changes were related to those of systemic vascular resistance (continue component) and of arterial compliance (pulsatile component).

Report this publication

Statistics

Seen <100 times