Dynamic arterial elastance predicts mean arterial pressure decrease associated with decreasing @entity1063 dosage in XXXX .

@entity1 @entity64 @entity295 @entity326 @entity1063
INTRODUCTION: Gradual reduction of the dosage of @entity1063 (NE) in @entity1 with @entity326 is usually left to the physician's discretion. No hemodynamic indicator predictive of the possibility of decreasing the NE dosage is currently available at the bedside. The respiratory pulse pressure variation/respiratory @entity64 volume variation (dynamic arterial elastance (Eadyn)) ratio has been proposed as an indicator of vascular tone. The purpose of this study was to determine whether Eadyn can be used to predict the decrease in arterial pressure when decreasing the NE dosage in resuscitated @entity295 @entity1 . METHODS: A prospective study was carried out in a university hospital intensive care unit. All consecutive @entity1 with @entity326 monitored by PICCO2 for whom the intensive care physician planned to decrease the NE dosage were enrolled. Measurements of hemodynamic and PICCO2 variables were obtained before/after decreasing the NE dosage. Responders were defined by a >15% decrease in mean arterial pressure (MAP). RESULTS: In total, 35 @entity1 were included. MAP decreased by >15% after decreasing the NE dosage in 37% of @entity1 (n   =   13). Clinical characteristics appeared to be similar between responders and nonresponders. Eadyn was lower in responders than in nonresponders (0.75 (0.69 to 0.85) versus 1 (0. 83 to 1.22), P   <0.05). Baseline Eadyn was correlated with NE-induced MAP variations (r   =   0.47, P   =   0.005). An Eadyn less than 0.94 predicted a decrease in arterial pressure, with an area under the receiver-operating characteristic curve of 0.87 (95% confidence interval (95% CI): 0.72 to 0.96; P   <0.0001), 100% sensitivity, and 68% specificity. CONCLUSIONS: In @entity295 @entity1 treated with NE, Eadyn may predict the decrease in arterial pressure in response to NE dose reduction. Eadyn may constitute an easy-to-use functional approach to arterial-tone assessment, which may be helpful to identify @entity1 likely to benefit from NE dose reduction.
