Estimation of mean systemic filling pressure in postoperative cardiac surgery patients with three methods

• DOI: 10.1007/s00134-012-2586-0
• Publication Date: 2012-05-14T13:34:28Z
• Authors: Jacinta J. Maas; Michael R. Pinsky; Bart F. Geerts; Rob B. de Wilde; Jos R. Jansen
• Keywords: Venous return; Cardiac output; Male; Time Factors; Original; Mean systemic filling pressure; Blood Pressure; Coronary Artery Disease; Critical Care and Intensive Care Medicine; Statistics, Nonparametric; 03 medical and health sciences; 0302 clinical medicine; Humans; Postoperative Period; Cardiac Output; Cardiac Surgical Procedures; Aged; Aged, 80 and over; Hemodynamics; Middle Aged; Circulation; Guyton; Female; Venous Pressure

To assess the level of agreement between different bedside estimates effective circulating blood volume—mean systemic filling pressure (Pmsf), arm equilibrium (Parm) and model analog (Pmsa)—in ICU patients. Eleven mechanically ventilated postoperative cardiac surgery patients were studied. Sequential measures made in supine position, rotating bed to a 30° head-up tilt after fluid loading (500 ml colloid). During each condition four inspiratory hold maneuvers done determine Pmsf; stop-flow was created by inflating cuff around upper for 30 s measure Parm, Pmsa estimated from Guytonian circulation. Mean Pmsf, Parm across all three states 20.9 ± 5.6, 19.8 5.7 14.9 4.0 mmHg, respectively. Bland-Altman analysis difference Pmsf showed non-significant bias −1.0 3.08 mmHg (p = 0.062), coefficient variation (COV) 15 %, limits (LOA) −7.3 5.2 mmHg. For we found −6.0 3.1 < 0.001), COV 17 % LOA −12.4 0.3 Changes directionally concordant response volume loading. are interchangeable circulatory tracked well changes Pmsa.