Top

Published in:

01-10-2016 | Understanding the Disease

Understanding arterial load

Authors: Manuel Ignacio Monge García, Paula Saludes Orduña, Maurizio Cecconi

Published in: Intensive Care Medicine | Issue 10/2016

Excerpt

The heart and the arterial system are anatomically and functionally connected, although they are frequently studied as separate structures with independent functions. The arterial tree does not act solely as mere conduits for blood flow distribution to the organs but it also modulates the ventricular ejection, transforming the pulsatile stroke volume (SV) into a peripheral continuous flow (essential for metabolic exchange), and maintaining blood pressure (BP) during diastole (necessary for coronary perfusion). Therefore, a complete description of the cardiovascular system should consider not only the cardiac function but also the arterial system and how both work with each other [1, 2]. …

Starling MR (1993) Left ventricular-arterial coupling relations in the normal human heart. Am Heart J 125:1659–1666CrossRefPubMed

Sunagawa K, Maughan WL, Burkhoff D, Sagawa K (1983) Left ventricular interaction with arterial load studied in isolated canine ventricle. Am J Physiol 245:H773–H780PubMed

Kelly RP, Ting CT, Yang TM, Liu CP, Maughan WL, Chang MS, Kass DA (1992) Effective arterial elastance as index of arterial vascular load in humans. Circulation 86:513–521CrossRefPubMed

Milnor WR (1975) Arterial impedance as ventricular afterload. Circ Res 36:565–570CrossRefPubMed

Nichols WW, O’Rourke M (2005) McDonald’s blood flow in arteries: theoretical, experimental and clinical principles. Oxford University Press, Oxford

Guarracino F, Baldassarri R, Pinsky MR (2013) Ventriculo-arterial decoupling in acutely altered hemodynamic states. Crit Care 17:213CrossRefPubMedPubMedCentral

Chantler PD, Lakatta EG (2012) Arterial-ventricular coupling with aging and disease. Front Physiol 3:90CrossRefPubMedPubMedCentral

Ky B, French B, May Khan A, Plappert T, Wang A, Chirinos JA, Fang JC, Sweitzer NK, Borlaug BA, Kass DA, St John Sutton M, Cappola TP (2013) Ventricular-arterial coupling, remodeling, and prognosis in chronic heart failure. J Am Coll Cardiol 62:1165–1172CrossRefPubMedPubMedCentral

Cecconi M, Hofer C, Teboul JL, Pettila V, Wilkman E, Molnar Z, Della Rocca G, Aldecoa C, Artigas A, Jog S, Sander M, Spies C, Lefrant JY, De Backer D, Investigators F, Group ET (2015) Fluid challenges in intensive care: the FENICE study: a global inception cohort study. Intensive Care Med 41:1529–1537CrossRefPubMedPubMedCentral

10.

Monge Garcia MI, Guijo Gonzalez P, Gracia Romero M, Gil Cano A, Oscier C, Rhodes A, Grounds RM, Cecconi M (2015) Effects of fluid administration on arterial load in septic shock patients. Intensive Care Med 41:1247–1255CrossRefPubMed

11.

Monge Garcia MI, Romero MG, Cano AG, Rhodes A, Grounds RM, Cecconi M (2013) Impact of arterial load on the agreement between pulse pressure analysis and esophageal Doppler. Crit Care 17:R113CrossRefPubMedPubMedCentral

12.

Maas JJ, de Wilde RB, Aarts LP, Pinsky MR, Jansen JR (2012) Determination of vascular waterfall phenomenon by bedside measurement of mean systemic filling pressure and critical closing pressure in the intensive care unit. Anesth Analg 114:803–810CrossRefPubMedPubMedCentral

13.

Westerhof N, Lankhaar JW, Westerhof BE (2009) The arterial Windkessel. Med Biol Eng Comput 47:131–141CrossRefPubMed

14.

Sunagawa K, Maughan WL, Sagawa K (1985) Optimal arterial resistance for the maximal stroke work studied in isolated canine left ventricle. Circ Res 56:586–595CrossRefPubMed

15.

Morimont P, Lambermont B, Ghuysen A, Gerard P, Kolh P, Lancellotti P, Tchana-Sato V, Desaive T, D’Orio V (2008) Effective arterial elastance as an index of pulmonary vascular load. Am J Physiol Heart Circ Physiol 294:H2736–H2742CrossRefPubMed

16.

Monge Garcia M, Gracia Romero M, Gil Cano A, Aya HD, Rhodes A, Grounds R, Cecconi M (2014) Dynamic arterial elastance as a predictor of arterial pressure response to fluid administration: a validation study. Crit Care 18:626CrossRef

Title: Understanding arterial load
Authors: Manuel Ignacio Monge García
Paula Saludes Orduña
Maurizio Cecconi
Publication date: 01-10-2016
Publisher: Springer Berlin Heidelberg
Published in: Intensive Care Medicine / Issue 10/2016
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-016-4212-z

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Understanding arterial load

Excerpt

Keynote webinar | Spotlight on medication adherence

Springer Medicine

Excerpt

Please log in to get access to this content

Other articles of this Issue 10/2016

Beta-Lactam Infusion in Severe Sepsis (BLISS): a prospective, two-centre, open-labelled randomised controlled trial of continuous versus intermittent beta-lactam infusion in critically ill patients with severe sepsis

Coagulopathy in fulminant liver failure with ultimately fatal clot formation

Heart rate reduction with esmolol is associated with improved arterial elastance in patients with septic shock: a prospective observational study

Beta-blockers in septic shock to optimize hemodynamics? We are not sure

Continuous infusion of β-lactam antibiotics for all critically ill patients?

Severe ARDS in a critically ill influenza patient with invasive pulmonary aspergillosis