Systolic-dicrotic notch pressure difference can identify tachycardic patients with septic shock at risk of cardiovascular decompensation following pharmacological heart rate reduction.


Journal

British journal of anaesthesia
ISSN: 1471-6771
Titre abrégé: Br J Anaesth
Pays: England
ID NLM: 0372541

Informations de publication

Date de publication:
12 2020
Historique:
received: 17 03 2020
revised: 27 05 2020
accepted: 28 05 2020
pubmed: 22 7 2020
medline: 15 12 2020
entrez: 22 7 2020
Statut: ppublish

Résumé

During sepsis, heart rate (HR) reduction could be a therapeutic target, but identification of responders (non-compensatory tachycardia) and non-responders (compensatory for 'fixed' stroke volume [SV]) is challenging. We tested the ability of the difference between systolic and dicrotic pressure (SDP In this post hoc analysis of 45 patients with septic shock with persistent tachycardia, we characterised features of haemodynamic response focusing on SDP After reducing HR, arterial dP/dt A decrease in SDP NCT02188888.

Sections du résumé

BACKGROUND
During sepsis, heart rate (HR) reduction could be a therapeutic target, but identification of responders (non-compensatory tachycardia) and non-responders (compensatory for 'fixed' stroke volume [SV]) is challenging. We tested the ability of the difference between systolic and dicrotic pressure (SDP
METHODS
In this post hoc analysis of 45 patients with septic shock with persistent tachycardia, we characterised features of haemodynamic response focusing on SDP
RESULTS
After reducing HR, arterial dP/dt
CONCLUSIONS
A decrease in SDP
CLINICAL TRIAL REGISTRATION
NCT02188888.

Identifiants

pubmed: 32690246
pii: S0007-0912(20)30446-3
doi: 10.1016/j.bja.2020.05.058
pii:
doi:

Substances chimiques

Adrenergic beta-Antagonists 0
Propanolamines 0
Vasoconstrictor Agents 0
esmolol MDY902UXSR
Norepinephrine X4W3ENH1CV

Banques de données

ClinicalTrials.gov
['NCT02188888']

Types de publication

Journal Article Observational Study

Langues

eng

Sous-ensembles de citation

IM

Pagination

1018-1024

Commentaires et corrections

Type : CommentIn

Informations de copyright

Copyright © 2020 British Journal of Anaesthesia. Published by Elsevier Ltd. All rights reserved.

Auteurs

Andrea Morelli (A)

Department of Internal Clinical, Anesthesiological and Cardiovascular Sciences, University of Rome, 'La Sapienza', Rome, Italy. Electronic address: andrea.morelli@uniroma1.it.

Salvatore M Romano (SM)

Department of Experimental and Clinical Medicine, Unit of Internal Medicine and Cardiology, University of Florence, Florence, Italy.

Filippo Sanfilippo (F)

Department of Anesthesia and Intensive Care, Policlinico-Vittorio Emanuele University Hospital, Catania, Italy.

Cristina Santonocito (C)

Department of Anesthesia and Intensive Care, Policlinico-Vittorio Emanuele University Hospital, Catania, Italy.

Giacomo Frati (G)

Department of Medico-Surgical Sciences and Biotechnologies, University of Rome 'La Sapienza', Rome, Italy; Department of AngioCardioNeurology, IRCCS Neuromed, Pozzilli, Italy.

Marco Chiostri (M)

Department of Experimental and Clinical Medicine, Unit of Internal Medicine and Cardiology, University of Florence, Florence, Italy.

Felice E Agrò (FE)

Unit of Anaesthesia, Intensive Care and Pain Management, Department of Medicine, Università Campus Bio-Medico di Roma, Rome, Italy.

Christian Ertmer (C)

Department of Anesthesiology, Intensive Care and Pain Medicine, University Hospital of Muenster, Muenster, Germany.

Sebastian W Rehberg (SW)

Department of Anesthesiology, Intensive Care, Emergency Medicine, Transfusion Medicine and Pain Therapy, Protestant Hospital of the Bethel Foundation, Bielefeld, Germany.

Antoine Vieillard-Baron (A)

Intensive Care Medicine Unit, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise, Boulogne-Billancourt, France; INSERM UMR-1018, CESP, Team Kidney and Heart, University of Versailles Saint-Quentin en Yvelines, Villejuif, France.

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Classifications MeSH