原创力文档non-invasive assessment of fluid responsiveness by changes in partial end-tidal co2 pressure during a passive leg-raising maneuver非侵入性评估流体响应的变化部分end-tidal二氧化碳压力在一个被动的腿抬高回旋余地.pdfVIP
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non-invasive assessment of fluid responsiveness by changes in partial end-tidal co2 pressure during a passive leg-raising maneuver非侵入性评估流体响应的变化部分end-tidal二氧化碳压力在一个被动的腿抬高回旋余地
Monge García et al. Annals of Intensive Care 2012, 2:9
/content/2/1/9
RESEARCH Open Access
Non-invasive assessment of fluid responsiveness
by changes in partial end-tidal CO2 pressure
during a passive leg-raising maneuver
*
Manuel Ignacio Monge García , Anselmo Gil Cano, Manuel Gracia Romero, Rocío Monterroso Pintado,
Virginia Pérez Madueño and Juan Carlos Díaz Monrové
Abstract
Background: The passive leg-raising (PLR) maneuver provides a dynamic assessment of fluid responsiveness
inducing a reversible increase in cardiac preload. Since its effects are sudden and transitory, a continuous cardiac
output (CO) monitoring is required to appropriately assess the hemodynamic response of PLR. On the other hand,
changes in partial end-tidal CO pressure (PETCO ) have been demonstrated to be tightly correlated with changes
2 2
in CO during constant ventilation and stable tissue CO production (VCO ). In this study we tested the hypothesis
2 2
that, assuming a constant VCO2 and under fixed ventilation, PETCO2 can track changes in CO induced by PLR and
can be used to predict fluid responsiveness.
Methods: Thirty-seven mechanically ventilated patients with acute circulatory failure were monitored with the
CardioQ-ODM esophageal Doppler. A 2-minutes PLR maneuver was performed. Fluid responsiveness was defined
according to CO increase (responders ≥ 15%) after volume expansion.
Results: PLR-induced increases in CO and PETCO2 were strongly correlated (R2 = 0.79; P 0.0001). The areas under
the receiver-operating characteristics (ROC) curve for a PLR-induced increase in CO and PETCO2 (0.97 ± 0.03 SE; CI
95%: 0.85 to 0.9
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