Observational studyCritical care (London, England)2013
Impact of arterial load on the agreement between pulse pressure analysis and esophageal Doppler.
Observational study in Critical care (London, England), 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
9 citing papers in PubMed, 43 citations in OpenAlex.
- Trial
- Haemodynamic Optimization by Oesophageal Doppler and Pulse Power Wave Analysis in Liver Surgery: A Randomised Controlled Trial.PloS one · 2015Trial
- Cardiac Output Evaluation on Septic Shock Patients: Comparison between Calibrated and Uncalibrated Devices during Vasopressor Therapy.Journal of clinical medicine · 2021Article
- Reliability of effective arterial elastance using peripheral arterial pressure as surrogate for left ventricular end-systolic pressure.Journal of clinical monitoring and computing · 2019Article
- Evaluation of cardiac output variations with the peripheral pulse pressure to mean arterial pressure ratio.Journal of clinical monitoring and computing · 2019Observational
- Understanding arterial load.Intensive care medicine · 2016Review
- Agreement between stroke volume measured by oesophageal Doppler and uncalibrated pulse contour analysis during fluid loads in severe aortic stenosis.Journal of clinical monitoring and computing · 2015Observational
- Effects of fluid administration on arterial load in septic shock patients.Intensive care medicine · 2015Article
- Dynamic arterial elastance as a predictor of arterial pressure response to fluid administration: a validation study.Critical care (London, England) · 2014Observational
Corrections and comments
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Authors and funding
6 authors at 3 institutions in 2 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
introductionThe reliability of pulse pressure analysis to estimate cardiac output is known to be affected by arterial load changes. However, the contribution of each aspect of arterial load could be substantially different. In this study, we evaluated the agreement of eight non-commercial algorithms of pulse pressure analysis for estimating cardiac output (PPCO) with esophageal Doppler cardiac output (EDCO) during acute changes of arterial load. In addition, we aimed to determine the optimal arterial load parameter that could detect a clinically significant difference between PPCO and the EDCO.
methodsWe included mechanically ventilated patients monitored with a prototype esophageal Doppler (CardioQ-Combi™, Deltex Medical, Chichester, UK) and an indwelling arterial catheter who received a fluid challenge or in whom the vasoactive medication was introduced or modified. Initial calibration of PPCO was made with the baseline value of EDCO. We evaluated several aspects of arterial load: total systemic vascular resistance (TSVR=mean arterial pressure [MAP]/EDCO*80), net arterial compliance (C=EDCO-derived stroke volume/pulse pressure), and effective arterial elastance (Ea=0.9*systolic blood pressure/EDCO-derived stroke volume). We compared CO values with Bland-Altman analysis, four-quadrant plot and a modified polar plot (with least significant change analysis).
resultsA total of 16,964-paired measurements in 53 patients were performed (median 271; interquartile range: 180-415). Agreement of all PPCO algorithms with EDCO was significantly affected by changes in arterial load, although the impact was more pronounced during changes in vasopressor therapy. When looking at different parameters of arterial load, the predictive abilities of Ea and C were superior to TSVR and MAP changes to detect a PPCO-EDCO discrepancy≥10% in all PPCO algorithms. An absolute Ea change>8.9±1.7% was associated with a PPCO-EDCO discrepancy≥10% in most algorithms.
conclusionsChanges in arterial load profoundly affected the agreement of PPCO and EDCO, although the contribution of each aspect of arterial load to the PPCO-EDCO discrepancies was significantly different. Changes in Ea and C mainly determined PPCO-EDCO discrepancy.
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