0000000000605773
AUTHOR
Samir G. Sakka
B-Lines for the assessment of extravascular lung water: Just focused or semi-quantitative?
BACKGROUND B-lines as typical artefacts of lung ultrasound are considered as surrogate measurement for extravascular lung water. However, B-lines develop in the sub-pleural space and do not allow assessment of the whole lung. Here, we present data from the first observational multi-centre study focusing on the correlation between a B-lines score and extravascular lung water in critically ill patients suffering from a variety of diseases. PATIENTS AND METHODS In 184 adult patients, 443 measurements were obtained. B-lines were counted and expressed in a score which was compared to extravascular lung water, measured by single-indicator transpulmonary thermodilution. Appropriate correlation coe…
Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: a multi-center, prospective, randomized study
Introduction Several single-center studies and meta-analyses have shown that perioperative goal-directed therapy may significantly improve outcomes in general surgical patients. We hypothesized that using a treatment algorithm based on pulse pressure variation, cardiac index trending by radial artery pulse contour analysis, and mean arterial pressure in a study group (SG), would result in reduced complications, reduced length of hospital stay and quicker return of bowel movement postoperatively in abdominal surgical patients, when compared to a control group (CG). Methods 160 patients undergoing elective major abdominal surgery were randomized to the SG (79 patients) or to the CG (81 patien…
Global End-Diastolic Volume
Global end-diastolic volume (GEDV) as determined at the bedside by the transpulmonary technique is a reliable marker of cardiac preload in critically ill patients. As shown by numerous studies, GEDV is superior to cardiac filling pressures in various settings in anesthesia and intensive care medicine in patients undergoing mechanical ventilation. Furthermore, in scenarios such as open-chest conditions, GEDV should be particularly considered and used for these purposes as dynamic parameters are associated with limitations. Clinical data from patients undergoing elective cardiac and noncardiac surgery showed that goal-directed treatment using GEDV for preload assessment is associated with the…