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Review
. 2023 Dec 7;11(1):87.
doi: 10.1186/s40635-023-00573-9.

Pathophysiological implications of ventriculoarterial coupling in septic shock

Michael R Pinsky  1 , Fabio Guarracino  2
Affiliations
Review

Pathophysiological implications of ventriculoarterial coupling in septic shock

Michael R Pinsky et al. Intensive Care Med Exp. .
No abstract available

Keywords: Arterial elastance; Coupling; Resuscitation; Sepsis; Septic shock; Ventricular elastance.

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Conflict of interest statement

None.

Figures

Fig. 1
Fig. 1
Pressure/volume loop describing ventriculo-arterial coupling. Plv left ventricular pressure, Vlv left ventricular volume, ESP left ventricle end-systolic pressure, ESV left ventricle end-systolic volume, EDV left ventricle end-diastolic volume, Ea arterial elastance, Ees end-systolic elastance, VAC ventriculo-arterial coupling, LVeff left ventricular efficiency, PVA pressure/volume area, SW stroke work, PE potential energy, SV stroke volume. Modified from Guarracino et al. (2019) Cardiovascular determinants of resuscitation from sepsis and septic shock. Crit Care 23:118 (http://creativecommons.org/licenses/by/4.0/)
Fig. 2
Fig. 2
Effect of alterations in either Ees (A) or Ea (B) on stroke volume. P left ventricular pressure, V left ventricular volume, ESP left ventricle end-systolic pressure, EDP left ventricle end-diastolic pressure, ESV left ventricle end-systolic volume, EDV left ventricle end-diastolic volume, Ea arterial elastance, Ees end-systolic elastance
Fig. 3
Fig. 3
Effect of vasopressor on systolic pressure and stroke volume in the presence of reduced Ees. P left ventricular pressure, V left ventricular volume, ESP left ventricle end-systolic pressure, EDP left ventricle end-diastolic pressure, ESV left ventricle end-systolic volume, EDV left ventricle end-diastolic volume, Ea arterial elastance, Ees end-systolic elastance, VAC ventriculo-arterial coupling, LVeff left ventricular efficiency, CO cardiac output, CI cardiac index, NE norepinephrine. Modified from Guarracino et al. (2019) Cardiovascular determinants of resuscitation from sepsis and septic shock. Critical Care 23:118 (http://creativecommons.org/licenses/by/4.0/)
Fig. 4
Fig. 4
Ventriculo-arterial coupling guided hemodynamic treatment. Ees ventricularelastance, EA arterialelastance, VAC ventriculo-arterialcoupling. (Modified from: Guarracino et al. Management of cardiovascular insufficiency in ICU: the BEAT approach. Minerva Anestesiol 2021 87(4):476–480. With permission.)
Fig. 5
Fig. 5
iElastance App. Operator inserted blood pressure, stroke volume, ejection fraction, and ejection times allows for the immediate display of Ea, Ees and VAC. On the right panel the echo images show how to measure the left ventricle ejection fraction (EF) and to detect the systolic ejection times. Abbreviations as defined in the text
See this image and copyright information in PMC

References

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