Fluid expansion improve ventriculo-arterial coupling in preload-dependent patients: a prospective observational study.

BMC Anesthesiology
Pierre HuettePierre-Grégoire Guinot

Abstract

The objectives of the present study was to evaluate the effect of fluid challenge (FC) on ventriculo-arterial (V-A) coupling, its determinants: arterial elastance and ventricular elastance, and ability to predict fluid responsiveness. Thirty patients admitted to cardio-thoracic ICU in whom the physician decided to perform FC were included. Arterial pressure, cardiac output, arterial elastance, and ventricular elastance, were measured before and after FC with 500 ml of lactated Ringer's solution. Fluid responders were defined as patients with more than a 15% increase in stroke volume. V-A coupling was evaluated by the arterial elastance to ventricular elastance ratio. Twenty-three (77%) of the 30 patients included in the study were fluid responders. Before FC, responders had higher arterial elastance and arterial elastance to ventricular elastance ratio. FC significantly increased mean arterial pressure, stroke volume and cardiac output, and significantly decreased systemic vascular resistance, arterial elastance and consequently the arterial elastance to ventricular elastance ratio. Changes in arterial elastance were correlated with changes in stroke volume, systemic vascular resistance, and arterial compliance. Baseline arteri...Continue Reading

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BETA
coronary artery bypass

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