Pulse pressure analysis to make a long story short 英文参考文献.docVIP

Cecconi and Rhodes Critical Care 2010,14:175 /content/14/4/175 COMMENTARY Pulse pressure analysis: to make a long story short Maurizio Cecconi and Andrew Rhodes* See related research by Monnet et al., /content/14/3/R109 that we can ensure that we use techniques that we can Abstract rely upon to be accurate and precise in the clinical Pulse pressure analysis algorithms are commonly used to measure cardiac output and to allow for the rational titration of therapy in critically ill patients. The ability of these algorithms to accurately track changes environ ment and also then integrate with therapies that are bene? cial to our patients. If we step back and look carefully at how these tools are used, then we would purport that there are two di? erent in stroke volume (and cardiac output) is thus very scenarios that could be discusse e ? rst scenario is important. Most of the currently available algorithms can provide robust data so long as there is no fundamental change in the vasomotor tone (arterial compliance or impedance). If the tone changes signi?cantly, for instance with vasodilatation or vasoconstriction, then the data become less robust. For this reason, unless there is a mechanism for compensating for changes in vasomotor tone, these algorithms are best used only over short time periods in order to get the most accurate and precise data on changes in cardiac output. where a snapshot of the circulatory status is required. is needs an accurate and precise measurement in order to provide useful informa e second scenario is where clinical interventions are titrated against changes in cardiac output - for instance, with a passive leg raise [8,9] or volume challenge [2]. In this scenario it is less relevant that we have an accurate and precise measurement, although it is more important that we can track the changes in the underlying signal reliably [10]. On the whole, the pulse pressure an