Dynamic Arterial Elastance as a Predictor of Arterial Blood Pressure Response to Fluid Administration in Septic Patients

Dynamic Arterial Elastance as a Predictor of Arterial Blood Pressure Response to Fluid Administration in Septic Patients

Correction of arterial hypotension is essential for adequate cellular metabolism. maintaining MAP above a minimum level has been recommended in order to prevent further tissue hypoperfusion and organ dysfunction.Functional assessment of arterial load by dynamic arterial elastance (Eadyn), has recently been shown to predict the arterial pressure response to volume expansion (VE) in hypotensive, preload-dependent septic patients.

After approval from the ethics and research committee of Faculty of Medicine, Cairo University, an informed consent will be obtained from each patient's next of kin. Arteial cathter will be inserted in radial artery and connected through an arterial line to invasive arterial blood pressure monitor. Electrical Cardiometry will be attached to patient through the placement of four skin sensors on the neck and left side of the thorax12. A set of hemodynamic measurements will be obtained at baseline and after infusing a fluid challenge (FC) of 150-250 ml normal saline over 5-10 minutes.Fluid-responders are patients with a SV increase ≥10% after fluid challenge (FC).

Inclusion Criteria:

• Adult patients (more than 18 years).
• Sepsis as a cause of admission.

Exclusion Criteria:

• • Patients younger than 18 years of age.

  • Pregnant females.
  • Trauma as a cause of intensive care unit (ICU)admission.
  • Known medical history of vasodilator therapy.
  • Cardiac arrhythmias.
  • Any absolute contraindication for fluid administration such as congestive heart failure, pulmonary edema and/or fluid overload