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Dynamic Arterial Elastance Obtained Using Arterial Signal Does Not Predict An Increase In Arterial Pressure After A Volume Expansion in the Operating Room.

dc.rights.licenseopenen_US
dc.contributor.authorLANCHON, R.
dc.contributor.authorNOUETTE-GAULAIN, Karine
dc.contributor.authorSTECKEN, L.
dc.contributor.authorSESAY, M.
dc.contributor.authorLEFRANT, J. Y.
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorBIAIS, M.
dc.date.accessioned2020
dc.date.available2020
dc.date.issued2017
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/20887
dc.description.abstractEnINTRODUCTION: Dynamic arterial elastance (Eadyn) is defined as the ratio between pulse pressure variations (PPV) and stroke volume variations (SVV). Eadyn has been proposed to predict an increase in mean arterial pressure (MAP) after volume expansion with conflicting results. The aim of the present study was to test the reliability of Eadyn in hypotensive patients (MAP\textless65mmHg) in the operating room (OR). PATIENTS AND METHODS: The study pooled data from 51 patients. They were included after the induction of anesthesia and before skin incision. Eadyn, MAP and stroke volume (FloTracTM, VigileoTM, Edwards-Lifesciences, Irvine,CA) were recorded before and after volume expansion (500ml starch 6% given over 10minutes). Pressure-responders were defined as an increase MAP≥15% after volume expansion. Changes in MAP were predicted using the area under the curves (AUC) with their 95%Confidence Interval(95%CI) derived from Receiver Operating Characteristic curves. RESULTS: Seventeen patients responded to volume expansion. Heart rate, PPV, SVV and Eadyn were similar between pressure responders and non-responders. Baseline values of stroke volume, cardiac output and MAP were lower in responders. Volume expansion induced significant variations in stroke volume, cardiac output, SVV and PPV, but not in Eadyn. Baseline Eadyn failed to predict MAP increase (AUC=0.53,95%CI=0.36-0.70,P\textgreater0.05) and was not correlated with volume expansion-induced changes in MAP (P\textgreater0.05). In preload responsive patients (changes in SV≥15% after volume expansion,n=24), the AUC was 0.54(95%CI=0.29-0.78;P\textgreater0.05). CONCLUSION:In the present study performed in the OR and in hypotensive patients, Eadyn obtained using arterial signal was unable to predict an increase in MAP after volume expansion.
dc.language.isoENen_US
dc.subject*Article CLINIQUE
dc.subject.enArterial Elastance
dc.subject.enArterial pressure
dc.subject.enPulse Pressure Variation
dc.subject.enStroke Volume Variation
dc.subject.enVolume expansion
dc.title.enDynamic Arterial Elastance Obtained Using Arterial Signal Does Not Predict An Increase In Arterial Pressure After A Volume Expansion in the Operating Room.
dc.title.alternativeAnaesth Crit Care Pain Meden_US
dc.typeArticle de revueen_US
dc.identifier.doi10.1016/j.accpm.2017.05.001en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
bordeaux.journalAnaesth Crit Care Pain Meden_US
bordeaux.page377–382en_US
bordeaux.volume36en_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires - U1034en_US
bordeaux.issue6en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
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