Transesophageal Pulsed Doppler echocardiography of pulmonary venous flow to assess left ventricular filling pressure in ventilated patients with acute respiratory distress syndrome.
J Crit Care
; 19(3): 187-97, 2004 Sep.
Article
em En
| MEDLINE
| ID: mdl-15484180
ABSTRACT
OBJECTIVE:
To determine whether the systolic fraction (SF) of the pulmonary venous flow (PVF), measured by transesophageal echocardiography (TEE) could be used to estimate the pulmonary artery occlusion pressure (PAOP).DESIGN:
Prospective clinical investigation. PATIENTS Nineteen intubated patients with ARDS.INTERVENTIONS:
Doppler examinations with measurement of the SF of the PVF (ie, the systolic velocity-time integral expressed as a fraction of the sum of systolic and early diastolic velocity-time integrals) were performed simultaneously with measurements of PAOP via a right heart catheter at 0 cmH2O PEEP (ZEEP), at PEEP = 8 cmH20 and at PEEP = 16 cmH2O. MEASUREMENTS AND MAINRESULTS:
At ZEEP, PAOP was inversely correlated with the SF of the PVF (r = -.89). The difference of SF between the group with PAOP <18 mm Hg and the group with PAOP > or = 18 mm Hg was statistically significant (P < .05). A SF > or = 55% predicted a PAOP < 15 mm Hg with a positive predictive value of 100% (95% CI = 63-100%). A SF < or = 40% predicted a PAOP > or =18 mm Hg with a positive predictive value of 100% (95% CI = 52-100%). At PEEP = 8 cm H20 (12 patients studied) and at PEEP = 16 cmH2O (10 patients studied), PAOP was inversely correlated with the SF of the PVF r = -.84, and r = -.85, respectively.CONCLUSION:
The SF of the PVF measured by Pulsed Doppler TEE seems to be a valuable index to estimate the left ventricular filling pressure in mechanically ventilated patients with ARDS.
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Base de dados:
MEDLINE
Assunto principal:
Síndrome do Desconforto Respiratório
/
Circulação Pulmonar
/
Respiração com Pressão Positiva
Limite:
Humans
/
Middle aged
Idioma:
En
Ano de publicação:
2004
Tipo de documento:
Article