Protocolized Cardiovascular Management Based on Ventricular-arterial Coupling

  • M. R. Pinsky
Part of the Update in Intensive Care and Emergency Medicine book series (volume 42)


Stroke Volume Mean Arterial Pressure Atrial Pressure Pulse Pressure Variation Stroke Volume Variation 


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Pinsky MR (2002) Functional hemodynamic monitoring: Applied physiology at the bedside. In: Vincent JL (ed) Yearbook of Emergency and Intensive Care Medicine Springer-Verlag, Heidelberg, pp 537–552Google Scholar
  2. 2.
    Iberti TJ, Fischer EP, Leibowitz AB, et al (1990) Amulticenter study of a physician’s knowledge of the pulmonary artery catheter. JAMA 264:2928–2932CrossRefPubMedGoogle Scholar
  3. 3.
    Connors AF Jr, Speroff T, Dawson NV, et al (1996) The effectiveness of right heart catheterization in the initial care of critically ill patients. SUPPORT Investigators. JAMA 276:889–897CrossRefPubMedGoogle Scholar
  4. 4.
    Hays MA, Timmins AC, Yau EH, Palazzo M, Hinds CJ, Watson D(1994) Elevation of systemic oxygen delivery in the treatment of critically ill patients. N Engl J Med 330:1717–1722CrossRefPubMedGoogle Scholar
  5. 5.
    Richard C, Warszawski J, Agnuel N, et al (2003) Early use of the pulmonary artery catheter and outcome in patients with shock and acute respiratory distress syndrome. JAMA 290:2713–2720CrossRefPubMedGoogle Scholar
  6. 6.
    Lichtwarck-Aschoff M, Zeravik J, Pfeiffer UJ (1992) Intrathoracic blood volume accurately reflects circulatory volume status in critically ill patients with mechanical ventilation. Intensive Care Med 18:137–138CrossRefGoogle Scholar
  7. 7.
    Pinsky MR, Vincent JL, DeSmet JM (1991) Estimating left ventricular filling pressure during positive end-expiratory pressure in humans. Am Rev Respir Dis 143:25–31PubMedGoogle Scholar
  8. 8.
    Jellinek H, Krafft P, Fitzgerald RD, Schwartz S, Pinsky MR (2000) Right atrial pressure predicts hemodynamic response to apneic positive airway pressure. Crit Care Med 28:672–678CrossRefPubMedGoogle Scholar
  9. 9.
    Magder S, Georgiadis G, Cheong T (1992) Respiratory variations in right atrial pressure predict the response to fluid challenge. J Crit Care 7:76–85CrossRefGoogle Scholar
  10. 10.
    Michard F, Chemla D, Richard C, et al (1999) Clinical use of respiratory changes in arterial pulse pressure to monitor the hemodynamic effects of PEEP. Am J Respir Crit Care Med 159:935–939PubMedGoogle Scholar
  11. 11.
    Michard F, Boussat S, Chemla D, et al (2000) Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 162:134–138PubMedGoogle Scholar
  12. 12.
    Diebel LN, Wilson RF, Heins J, et al (1994) End-diastolic volume versus pulmonary artery occlusion pressure in evaluating cardiac preload in trauma patients. J Trauma 37:950–955PubMedGoogle Scholar
  13. 13.
    Gunn SR, Harrigan PWJB, Denault AY, Gorcsan J III, Teboul JL, Pinsky MR (2002) Does pulse pressure variation correlate with conventional measures of preload? Crit Care Shock 5:170–176Google Scholar
  14. 14.
    Michard F, Alaya S, Zarka V, Bahloul M, Richard C, Teboul JL (2003) Global end-diastolic volume as a predictor of cardiac preload in patients with septic shock. Chest 124:1900–1908CrossRefPubMedGoogle Scholar
  15. 15.
    Madger S, Lagonidis D, Erice F (2001) The use of respiratory variations in right atrial pressure to predict the cardiac output response to PEEP. J Crit Care 16:108 114PubMedGoogle Scholar
  16. 16.
    Perel A, Pizov R, Cotev S (1987) Systolic blood pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage. Anesthesiology 67:498–502PubMedGoogle Scholar
  17. 17.
    Szold A, Pizov R, Segal E, Perel A (1989) The effect of tidal volume and intravascular volume state on systolic pressure variation in ventilated dogs. Intensive Care Med 15:368–371CrossRefPubMedGoogle Scholar
  18. 18.
    Tavernier B, Makhotine O, Lebuffe G, Dupont J, Scherpereel P (1998) Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology 89:1313–1321CrossRefPubMedGoogle Scholar
  19. 19.
    Denault AY, Gasior TA, Gorcsan J, Mandarino WA, Deneault LG, Pinsky MR (1999) Determinants of aortic pressure variation during positive-pressure ventilation in man. Chest 116:176–186CrossRefPubMedGoogle Scholar
  20. 20.
    Feissel M, Michard F, Mangin I, Ruyer O, Faller JP, Teboul JL (2001) Respiratory changes in aortic blood velocity as an indicator of fluid responsiveness in ventilated patients with septic shock. Chest 119:867–873CrossRefPubMedGoogle Scholar
  21. 21.
    Wesseling K, Wit BD, Weber J, Smith NT (1983) A simple device for the continuous measurement of cardiac output. Adv Cardiovasc Physiol 5:16–52Google Scholar
  22. 22.
    Sylvester JT, Gilbert RD, Traystman RJ, Permutt S (1981) Effects of hypoxia on the closing pressure of the canine systemic arterial circulation. Circ Res 49:980–987PubMedGoogle Scholar
  23. 23.
    Goedje O, Hoeke K, Lichtwarck-Aschoff M, Faltchauser A, Lamm P, Reichart B (1999) Continuous cardiac output by femoral arterial thermodilution calibrated pulse contour analysis: comparison with pulmonary arterial thermodilution. Crit Care Med 27:2407–2412CrossRefPubMedGoogle Scholar
  24. 24.
    Berkenstadt H, Margalit N, Hadani M, et al (2001) Stroke volume variation as a predictor of fluid responsiveness in patients undergoing brain surgery. Anesth Analg 92:984–989PubMedGoogle Scholar
  25. 25.
    Reuter DA, Felbinger TW, Kilger E, et al (2002) Optimizing fluid therapy in mechanically ventilated patients after cardiac surgery by on-line monitoring of left ventricular stroke volume variations. Comparison with aortic systolic pressure variations. Br J Anaesth 88:124–126CrossRefPubMedGoogle Scholar
  26. 26.
    Reuter DA, Felbinger TW, Schmidt C, et al (2002) Stroke volume variation for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery. Intensive Care Med 28:392–398CrossRefPubMedGoogle Scholar
  27. 27.
    Pinsky MR(1984) Determinants of pulmonary artery flow variation during respiration. J Appl Physiol 56:1237–1245Google Scholar
  28. 28.
    Pinsky MR, Matuschak GM, Klain M (1985) Determinants of cardiac augmentation by increases in intrathoracic pressure. J Appl Physiol 58:1189–1198PubMedGoogle Scholar
  29. 29.
    Abel JG, Salerno TA, Panos A, et al (1987) Cardiovascular effects of positive pressure ventilation in humans. Ann Thorac Surg 43:36–43Google Scholar
  30. 30.
    LeDoux D, Astiz ME, Carpati CM, Rackow EC (2000) Effects of perfusion pressure on tissue perfusion in septic shock. Crit Care Med 28:2729–2732CrossRefPubMedGoogle Scholar
  31. 31.
    Schlichtig R, Kramer D, Pinsky MR (1991) Flow redistribution during progressive hemorrhage is a determinant of critical O2 delivery. J Appl Physiol 70:169–178PubMedGoogle Scholar
  32. 32.
    Sunagawa K, Maughn WL, Burkhoff, Sagawa K (1983) Left ventricular interaction with arterial load studied in the isolated canine ventricle. Am J Physiol 245:H773–H785PubMedGoogle Scholar
  33. 33.
    Rivers E, Nguyen B, Havstad S, et al (2001) Early goal-directed therapy in the treatment of severe sepsis and septic shock. N Engl J Med 345:1368–1377CrossRefPubMedGoogle Scholar

Copyright information

© Springer-Verlag Berlin Heidelberg 2005

Authors and Affiliations

  • M. R. Pinsky

There are no affiliations available

Personalised recommendations