Can Transthoracic Echocardiography Be Used to Predict Fluid Responsiveness in the Critically Ill Patient A Systematic Review英文文献资料.docVIP

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Can Transthoracic Echocardiography Be Used to Predict Fluid Responsiveness in the Critically Ill Patient A Systematic Review英文文献资料.doc

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Can Transthoracic Echocardiography Be Used to Predict Fluid Responsiveness in the Critically Ill Patient A Systematic Review英文文献资料

HindawiPublishingCorporation CriticalCareResearchandPractice Volume2012,ArticleID513480,9pages doi:10.1155/2012/513480 ReviewArticle CanTransthoracicEchocardiographyBeUsedtoPredictFluid ResponsivenessintheCriticallyIllPatient?ASystematicReview JustinC.MandevilleandClaireL.Colebourn AdultIntensiveCareUnit,JohnRadcli?eHospitalOxford,HeadleyWay,Headington,OxfordOX39DU,UK CorrespondenceshouldbeaddressedtoJustinC.Mandeville,jmandeville@ Received3October2011;Accepted24October2011 AcademicEditor:DimitriosKarakitsos Copyright?2012J.C.MandevilleandC.L.Colebourn.ThisisanopenaccessarticledistributedundertheCreativeCommons AttributionLicense,whichpermitsunrestricteduse,distribution,andreproductioninanymedium,providedtheoriginalworkis properlycited. Introduction. Wesystematicallyevaluatedtheuseoftransthoracic echocardiographyintheassessmentofdynamicmarkersof preloadtopredict?uidresponsivenessinthecriticallyilladultpatient.Methods.Studiesinthecriticallyillusingtransthoracic echocardiography(TTE) topredictaresponseinstrokevolumeorcardiacoutputtoa?uidloadwereselected. Selectionwas limitedtoEnglishlanguageandadultpatients.Studiesonpatientswithanopenthoraxorabdomenwereexcluded.Results .The predictivepowerofdiagnosticaccuracyofinferiorvenacavadiameterandtransaorticDopplersignalchangeswiththerespiratory cycleorpassivelegraisinginmechanicallyventilatedpatientswasstrongthroughoutthearticlesreviewed. Limitationsofthe techniquerelatetopatienttoleranceoftheprocedure,adequacyofacousticwindows,andoperatorskill.Conclusions .Transthoracic echocardiographictechniquesaccuratelypredict?uidresponsivenessincriticallyillpatients.Discriminativepowerisnota?ected bythetechniqueselected. 1.Introduction toa?uidbolus.These“dynamic”markersmakeuseofpro- vokedcardiacreactionassessedwithouttheneedfora?uid bolus,insteadutilizingeithertheconsequencesofheart-lung interaction during ventilation or the response to postural changetomimicthee?ectofa?uidbolusonstrokevolume. Firstly,inmechanicallyve