Relationship between Microcirculatory Perfusion and Arterial Elastance: A Pilot Study
Joint Authors
Vincent, Jean-Louis
Franchi, Federico
Taccone, Fabio Silvio
Scolletta, Sabino
Bond, Ottavia
De Santis, Paolo
Iesu, Enrica
Creteur, Jacques
Source
Critical Care Research and Practice
Issue
Vol. 2019, Issue 2019 (31 Dec. 2019), pp.1-9, 9 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2019-03-26
Country of Publication
Egypt
No. of Pages
9
Main Subjects
Abstract EN
Background.
Arterial elastance (Ea) represents the total afterload imposed on the left ventricle, and it is largely influenced by systemic vascular resistance (SVR).
Although one can expect that Ea is influenced by peripheral endothelial function, no data are available to support it in patients.
The aim of this study was to investigate the relationship between Ea, SVR, and microvascular perfusion in critically ill patients undergoing the fluid challenge (FC).
Methods.
A prospective study in patients receiving a fluid challenge.
A pulse wave analysis system (MostCare, Vygon, France) was used to estimate Ea and an incident dark field (IDF) handheld device (Braedius Medical BV, The Netherlands) to evaluate the sublingual microcirculation.
Microvascular perfusion was assessed using the proportion of small-perfused vessels (PPV).
Relative changes in each variable were calculated before and after FC; fluid responsiveness was defined as an increase in the cardiac index by at least 10% from baseline.
Results.
We studied 20 patients requiring a fluid challenge (n=10 for hypotension; n=5 for oliguria; n=3 for lactate values greater than 2 mmol/l; n=2 for tachycardia), including 12 fluid responders.
There was a strong correlation between Ea and SVR (r2 = 0.75; p<0.001) and only a weak correlation between Ea and PPV at baseline (r2 = 0.22; p=0.04).
Ea decreased from 1.4 [1.2–1.6] to 1.2 [1.1–1.4] mmHg/mL (p=0.01), SVR from 1207 [1006–1373] to 1073 [997–1202] dyn ∗ s/cm5 (p=0.06), and PPV from 56 [51–64] % to 59 [47–73] % (p=0.25) after fluid challenge.
Changes in Ea were significantly correlated with changes in SVR, but not with changes in PPV.
Conclusions.
The correlation between Ea and indexes of microvascular perfusion in the sublingual region is weak.
The impact of microcirculatory perfusion on the arterial load is probably limited.
American Psychological Association (APA)
Bond, Ottavia& De Santis, Paolo& Iesu, Enrica& Franchi, Federico& Vincent, Jean-Louis& Creteur, Jacques…[et al.]. 2019. Relationship between Microcirculatory Perfusion and Arterial Elastance: A Pilot Study. Critical Care Research and Practice،Vol. 2019, no. 2019, pp.1-9.
https://search.emarefa.net/detail/BIM-1129099
Modern Language Association (MLA)
Bond, Ottavia…[et al.]. Relationship between Microcirculatory Perfusion and Arterial Elastance: A Pilot Study. Critical Care Research and Practice No. 2019 (2019), pp.1-9.
https://search.emarefa.net/detail/BIM-1129099
American Medical Association (AMA)
Bond, Ottavia& De Santis, Paolo& Iesu, Enrica& Franchi, Federico& Vincent, Jean-Louis& Creteur, Jacques…[et al.]. Relationship between Microcirculatory Perfusion and Arterial Elastance: A Pilot Study. Critical Care Research and Practice. 2019. Vol. 2019, no. 2019, pp.1-9.
https://search.emarefa.net/detail/BIM-1129099
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-1129099