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Transesophageal Pulsed Doppler echocardiography of pulmonary venous flow to assess left ventricular filling pressure in ventilated patients with acute respiratory distress syndrome.

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 MAIN RESULTS: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.

journal_name

J Crit Care

journal_title

Journal of critical care

authors

Vargas F,Gruson D,Valentino R,Bui HN,Salmi LR,Gilleron V,Gbikpi-Benissan G,Guenard H,Hilbert G

doi

10.1016/j.jcrc.2004.07.009

subject

Has Abstract

pub_date

2004-09-01 00:00:00

pages

187-97

issue

3

eissn

0883-9441

issn

1557-8615

pii

S0883944104000541

journal_volume

19

pub_type

临床试验,杂志文章

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