| Lee CH |
------>authors3_c= ------>paper_class1=1 ------>Impact_Factor=3.394 ------>paper_class3=2 ------>paper_class2=1 ------>vol= ------>confirm_bywho=None ------>insert_bywho=hwchiu ------>Jurnal_Rank=28.6 ------>authors4_c= ------>comm_author= ------>patent_EDate=None ------>authors5_c= ------>publish_day=1 ------>paper_class2Letter=None ------>page2= ------>medlineContent= ------>unit=E0700 ------>insert_date=20091008 ------>iam=4 ------>update_date=None ------>author=??? ------>change_event=1 ------>ISSN= ------>authors_c= ------>score=500 ------>journal_name=shock ------>paper_name=Pulse Pressure Power Spectrum Predicts Volume Responsiveness in Shock Patients without Sedation ------>confirm_date=None ------>tch_id=089136 ------>pmid=19924032 ------>page1= ------>fullAbstract=INTRODUCTION:: To investigate whether the pulse pressure power spectrum (PPPS) could predict the effect of volume expansion (VE) in shock patients under mechanical ventilation without sedation. METHODS:: The PPPS within a frequency band of 0.15-0.75 Hz was developed with an animal model using nine domesticated piglets simulating acute hemorrhagic shock and then validated in 17 non-sedated mechanical ventilated shock patients. Hemodynamic parameters were recorded before and after VE. RESULTS:: In animal model under anesthesia and pressure control ventilation, the absolute and proportional change of cardiac index after VE (DeltaCI and DeltaCI%) positively correlated with square root of PPPS (SQRT-PPPS, r-square: 0.34 and 0.72, respectively). The correlations were weaker with pulse pressure variation averaged on 120-second sliding window (PPV120, r-square: 0.27 and 0.64, respectively) and PPV30 (r-square: 0.28 and 0.63, respectively) under pressure control level 10 cmH2O. Defining the volume responder as DeltaCI% >/= 15%, the area under receiver operating characteristic curve (AROC) were equivalent for SQRT-PPPS (0.91), PPV120 (0.86) and PPV30 (0.85). For the 17 patients who had spontaneous breathing movements under assisted pressure control ventilation, the DeltaCI and DeltaCI% positively correlated with SQRT-PPPS (r-square: 0.35 and 0.73, respectively). The correlations were weaker with PPV120 (r-square: 0.27 and 0.42) and PPV30 (r-square: 0.27 and 0.40). The AROC were 0.78 for SQRT-PPPS (p = 0.047), 0.71 for PPV120, (p = 0.131) and 0.69 for PPV30 (p = 0.185). CONCLUSIONS:: In mechanically ventilated shock patients, SQRT-PPPS predicts volume responsiveness without the need for sedation to prevent spontaneous breathing movements. ------>tmu_sno=None ------>sno=22458 ------>authors2=Wang JY ------>authors3=Wu YK ------>authors4=Chiu HW ------>authors5=Lan CC ------>authors6=Chang H, Chen CY ------>authors6_c= ------>authors=Lee CH ------>delete_flag=0 ------>SCI_JNo=None ------>authors2_c= ------>publish_area=0 ------>updateTitle=Pulse Pressure Power Spectrum Predicts Volume Responsiveness in Shock Patients without Sedation. ------>language=2 ------>check_flag=None ------>submit_date=None ------>country=None ------>no= ------>patent_SDate=None ------>update_bywho=None ------>publish_year=2009 ------>submit_flag=None ------>publish_month=1 |