201. Evaluation of cardiac output variations with the peripheral pulse pressure to mean arterial pressure ratio
- Author
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Audrey Tantot, Etienne Gayat, Joaquim Mateo, Anais Caillard, Alexandre Mebazaa, Sandrine Millasseau, Fabrice Vallée, Arthur Le Gall, Hôpitaux Universitaires Saint-Louis, Lariboisière, Fernand-Widal, Institut National de la Santé et de la Recherche Médicale (INSERM), Mathematical and Mechanical Modeling with Data Interaction in Simulations for Medicine (M3DISIM), Laboratoire de mécanique des solides (LMS), École polytechnique (X)-MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École polytechnique (X)-MINES ParisTech - École nationale supérieure des mines de Paris, Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-Inria Saclay - Ile de France, Institut National de Recherche en Informatique et en Automatique (Inria)-Institut National de Recherche en Informatique et en Automatique (Inria), Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS), Pulse wave consulting [Saint-Leu-la-forêt], École polytechnique (X)-Mines Paris - PSL (École nationale supérieure des mines de Paris), and Université Paris sciences et lettres (PSL)-Université Paris sciences et lettres (PSL)-Centre National de la Recherche Scientifique (CNRS)-École polytechnique (X)-Mines Paris - PSL (École nationale supérieure des mines de Paris)
- Subjects
Adult ,Male ,medicine.medical_specialty ,Cardiac output ,Mean arterial pressure ,Operating Rooms ,[SDV.BIO]Life Sciences [q-bio]/Biotechnology ,Systole ,Health Informatics ,Blood Pressure ,Critical Care and Intensive Care Medicine ,Positive correlation ,Neurosurgical Procedures ,03 medical and health sciences ,Norepinephrine ,Phenylephrine ,0302 clinical medicine ,Bolus (medicine) ,[SDV.MHEP.CSC]Life Sciences [q-bio]/Human health and pathology/Cardiology and cardiovascular system ,030202 anesthesiology ,Heart Rate ,Internal medicine ,medicine ,Humans ,Vasoconstrictor Agents ,Anesthesia ,Arterial Pressure ,Ephedrine ,Cardiac Output ,ComputingMilieux_MISCELLANEOUS ,Aged ,Monitoring, Physiologic ,business.industry ,Hemodynamics ,030208 emergency & critical care medicine ,Stroke Volume ,Ultrasonography, Doppler ,Middle Aged ,Pulse pressure ,Peripheral ,Anesthesiology and Pain Medicine ,Cardiology ,Female ,[SDV.IB]Life Sciences [q-bio]/Bioengineering ,business ,medicine.drug - Abstract
Cardiac output (CO) optimisation during surgery reduces post-operative morbidity. Various methods based on pulse pressure analysis have been developed to overcome difficulties to measure accurate CO variations in standard anaesthetic settings. Several of these methods include, among other parameters, the ratio of pulse pressure to mean arterial pressure (PP/MAP). The aim of this study was to evaluate whether the ratio of radial pulse pressure to mean arterial pressure (ΔPPrad/MAP) could track CO variations (ΔCO) induced by various therapeutic interventions such as fluid infusions and vasopressors boluses [phenylephrine (PE), norepinephrine (NA) or ephedrine (EP)] in the operating room. Trans-oesophageal Doppler signal and pressure waveforms were recorded in patients undergoing neurosurgery. CO and PPrad/MAP were recorded before and after fluid challenges, PE, NA and EP bolus infusions as medically required during their anaesthesia. One hundred and three patients (mean age: 52 ± 12 years old, 38 men) have been included with a total of 636 sets of measurement. During fluids challenges (n = 188), a positive correlation was found between ΔPPrad/MAP and ΔCO (r = 0.22, p = 0.003). After PE (n = 256) and NA (n = 121) boluses, ΔPPrad/MAP positively tracked ΔCO (r = 0.53 and 0.41 respectively, p
- Published
- 2018