原创力文档arterial dpdtmax accurately reflects left ventricular contractility during shock when adequate vascular filling is achieved动脉dpdtmax准确地反映左心室收缩性休克期间适当的血管充盈.pdfVIP
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arterial dpdtmax accurately reflects left ventricular contractility during shock when adequate vascular filling is achieved动脉dpdtmax准确地反映左心室收缩性休克期间适当的血管充盈
Morimont et al. BMC Cardiovascular Disorders 2012, 12:13
/1471-2261/12/13
RESEARCH ARTICLE Open Access
Arterial dP/dtmax accurately reflects left
ventricular contractility during shock when
adequate vascular filling is achieved
1* 1 2 3 4
Philippe Morimont , Bernard Lambermont , Thomas Desaive , Nathalie Janssen , Geoffrey Chase and
Vincent D’Orio3
Abstract
Background: Peak first derivative of femoral artery pressure (arterial dP/dtmax) derived from fluid-filled catheter
remains questionable to assess left ventricular (LV) contractility during shock. The aim of this study was to test if
arterial dP/dtmax is reliable for assessing LV contractility during various hemodynamic conditions such as endotoxin-
induced shock and catecholamine infusion.
Methods: Ventricular pressure-volume data obtained with a conductance catheter and invasive arterial pressure
obtained with a fluid-filled catheter were continuously recorded in 6 anaesthetized and mechanically ventilated
pigs. After a stabilization period, endotoxin was infused to induce shock. Catecholamines were transiently
administrated during shock. Arterial dP/dtmax was compared to end-systolic elastance (Ees), the gold standard
method for assessing LV contractility.
Results: Endotoxin-induced shock and catecholamine infusion lead to significant variations in LV contractility.
Overall, significant correlation (r = 0.51; p 0.001) but low agreement between the two methods were observed.
However, a far better correlation with a good agreement were observed when positive-pressure ventilation
induced an arterial pulse pressure variation (PPV) ≤ 11% (r = 0.77; p 0.001).
Conclusion: While arterial dP/dtmax and Ees were significa
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