Echocardiographic Doppler estimation of pulmonary artery pressure in critically ill patients with severe hypoxemia
Abstract
BACKGROUND: In spontaneously breathing cardiac patients, pulmonary artery pressure (PAP) can be accurately estimated from the transthoracic Doppler study of pulmonary artery and tricuspid regurgitation blood flows. In critically ill patients on mechanical ventilation for acute lung injury, the interposition of gas between the probe and the heart renders the transthoracic approach problematic. This study was aimed at determining whether the transesophageal approach could offer an alternative. METHODS: Fifty-one consecutive sedated and ventilated patients with severe hypoxemia (arterial oxygen tension/fraction of inspired oxygen < 300) were prospectively studied. Mean PAP measured from the pulmonary artery catheter was compared with several indices characterizing pulmonary artery blood flow assessed using transesophageal echocardiography: preejection time, acceleration time, ejection duration, preejection time on ejection duration ratio, and acceleration time on ejection duration ratio. In a subgroup of 20 patients, systolic PAP measured from the pulmonary artery catheter immediately before withdrawal was compared with Doppler study of regurgitation tricuspid flow performed immediately after pulmonary artery catheter withdrawal using either the transthoracic or the transesophageal approach. RESULTS: Weak and clinically irrelevant correlations were found between mean PAP and indices of pulmonary artery flow. A statistically significant and clinically relevant correlation was found between systolic PAP and regurgitation tricuspid flow. In 3 patients (14%), pulmonary artery pressure could not be assessed echocardiographically. CONCLUSIONS: In hypoxemic patients on mechanical ventilation, mean PAP cannot be reliably estimated from indices characterizing pulmonary artery blood flow. Systolic PAP can be estimated from regurgitation tricuspid flow using either transthoracic or transesophageal approach. © 2008 American Society of Anesthesiologists, Inc.
How to cite this document
Keywords
Language
Collections

Related items
Showing items related by title, author, creator and subject.
-
Interação entre as vias de sinalização de receptores serotoninérgicos e Β-adrenérgicos em artéria femoral de ratos
Delbin, Maria Andréia; Silva, Alexandre Sérgio
; Antunes, Edson; Zanesco, Angelina
(Arquivos Brasileiros de Cardiologia, 2012) [Artigo]
Fundamento: A doença coronária tem sido amplamente estudada em pesquisas cardiovasculares. No entanto, pacientes com doença arterial periférica (DAP) têm piores resultados em comparação àqueles com doença arterial coronariana. ... -
Considerations sur la ramification de L'aorte abdominale du hamster (Mesocricetus Auratus)
Orsi, A. M.; Pinto Silva, E. P.; Mello Dias, S.; Oliveira, M. C. (Anatomischer Anzeiger, 1977) [Artigo]The disposition of the abdominal aorta branching in Mesocricetus auratus is described, establishing variation groups with relation to the celiac, cranial mesenteric, renal, genital and caudal mesenteric arteries. Sixty ... -
Interaction between serotoninergic-and beta-adrenergic receptors signaling pathways in rat femoral artery
Delbin, Maria Andréia; Silva, Alexandre Sérgio
; Antunes, Edson; Zanesco, Angelina
(Arquivos Brasileiros de Cardiologia, 2012) [Artigo]
Background: Coronary heart disease has been widely studied in cardiovascular research. However, patients with peripheral artery disease (PAD) have worst outcomes compared to those with coronary artery disease. Therefore, ...