Changes in Radial Artery Pulse Pressure During a Fluid Challenge Cannot Assess Fluid Responsiveness in Patients With Septic Shock
BACKGROUND: Arterial blood pressure is the most common variable used to assess the response to a fluid challenge in routine clinical practice. The aim of this study was to evaluate the accuracy of the change in the radial artery pulse pressure (rPP) to detect the change in cardiac output after a fluid challenge in patients with septic shock.
METHODS: Prospective observational study including 35 patients with septic shock in which rPP and cardiac output were measured before and after a fluid challenge with 400 mL of crystalloid solution. Cardiac output was measured with intermittent thermodilution technique using a pulmonary artery catheter. Patients were divided between responders (increase >15% of cardiac output after fluid challenge) and nonresponders. The area under the receiver operating characteristic curve (AUROC), Pearson correlation coefficient and paired Student t test were used in statistical analysis.
RESULTS: Forty-three percent of the patients were fluid responders. The change in rPP could not neither discriminate between responders and nonresponders (AUROC = 0.52; [95% confidence interval: 0.31-0.72] P = .8) nor correlate (r = .21, P = .1) with the change in cardiac output after the fluid challenge.
CONCLUSIONS: The change in rPP neither discriminated between fluid responders and nonresponders nor correlated with the change in cardiac output after a fluid challenge. The change in rPP cannot serve as a surrogate of the change in cardiac output to assess the response to a fluid challenge in patients with septic shock.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2020 |
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| Erschienen: |
2020 |
| Enthalten in: |
Zur Gesamtaufnahme - volume:35 |
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| Enthalten in: |
Journal of intensive care medicine - 35(2020), 2 vom: 01. Feb., Seite 149-153 |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
De la Puente-Diaz de Leon, Victor [VerfasserIn] |
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| Links: |
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| Themen: |
Cardiac output |
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| Anmerkungen: |
Date Completed 29.05.2020 Date Revised 11.04.2022 published: Print-Electronic Citation Status MEDLINE |
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| doi: |
10.1177/0885066617732291 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM276017870 |
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| 245 | 1 | 0 | |a Changes in Radial Artery Pulse Pressure During a Fluid Challenge Cannot Assess Fluid Responsiveness in Patients With Septic Shock |
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| 500 | |a Date Completed 29.05.2020 | ||
| 500 | |a Date Revised 11.04.2022 | ||
| 500 | |a published: Print-Electronic | ||
| 500 | |a Citation Status MEDLINE | ||
| 520 | |a BACKGROUND: Arterial blood pressure is the most common variable used to assess the response to a fluid challenge in routine clinical practice. The aim of this study was to evaluate the accuracy of the change in the radial artery pulse pressure (rPP) to detect the change in cardiac output after a fluid challenge in patients with septic shock | ||
| 520 | |a METHODS: Prospective observational study including 35 patients with septic shock in which rPP and cardiac output were measured before and after a fluid challenge with 400 mL of crystalloid solution. Cardiac output was measured with intermittent thermodilution technique using a pulmonary artery catheter. Patients were divided between responders (increase >15% of cardiac output after fluid challenge) and nonresponders. The area under the receiver operating characteristic curve (AUROC), Pearson correlation coefficient and paired Student t test were used in statistical analysis | ||
| 520 | |a RESULTS: Forty-three percent of the patients were fluid responders. The change in rPP could not neither discriminate between responders and nonresponders (AUROC = 0.52; [95% confidence interval: 0.31-0.72] P = .8) nor correlate (r = .21, P = .1) with the change in cardiac output after the fluid challenge | ||
| 520 | |a CONCLUSIONS: The change in rPP neither discriminated between fluid responders and nonresponders nor correlated with the change in cardiac output after a fluid challenge. The change in rPP cannot serve as a surrogate of the change in cardiac output to assess the response to a fluid challenge in patients with septic shock | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Observational Study | |
| 650 | 4 | |a cardiac output | |
| 650 | 4 | |a fluid challenge | |
| 650 | 4 | |a fluid responsiveness | |
| 650 | 4 | |a pulmonary artery catheter | |
| 650 | 4 | |a radial pulse pressure | |
| 650 | 4 | |a septic shock | |
| 650 | 7 | |a Crystalloid Solutions |2 NLM | |
| 700 | 1 | |a de Jesus Jaramillo-Rocha, Valente |e verfasserin |4 aut | |
| 700 | 1 | |a Teboul, Jean-Louis |e verfasserin |4 aut | |
| 700 | 1 | |a Garcia-Miranda, Sofia |e verfasserin |4 aut | |
| 700 | 1 | |a Martinez-Guerra, Bernardo A |e verfasserin |4 aut | |
| 700 | 1 | |a Dominguez-Cherit, Guillermo |e verfasserin |4 aut | |
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