logo SBA

ETD

Digital archive of theses discussed at the University of Pisa

 

Thesis etd-03302017-123242


Thesis type
Tesi di dottorato di ricerca
Author
BERTINI, PIETRO
URN
etd-03302017-123242
Thesis title
Ventriculo-Arterial Coupling in Critical Care Patients
Academic discipline
MED/41
Course of study
FISIOPATOLOGIA CLINICA
Supervisors
tutor Prof. Palombo, Carlo
tutor Dott. Guarracino, Fabio
Keywords
  • critical care
  • echocardiography
  • Elastance
  • hemodynamics
  • septic shock
Graduation session start date
25/04/2017
Availability
Full
Summary
Rapid diagnosis of hemodynamic derangement and proper therapy is crucial in critical care. Patients suffering from acute cardiovascular illness or septic shock are difficult to investigate using conventional hemodynamic parameters even if invasive.
Our aim was to apply measuring of ventriculo-arterial coupling (VAC) to those patients in a single-beat noninvasive fashion.
Firstly, we tested such methodology in cardiac surgery operating theatre using cardio pulmonary bypass as a model of hemodynamic derangement.
Subsequently, we measured VAC in the intensive care unit recruiting septic shock patients undergoing conventional treatment for hemodynamic resuscitation.
We found that VAC, Ea and Ees after fluid resuscitation are able to predict MAP increase after norepinephrine application, therefore we designed an algorithm in order to proper differentiate patients who might benefit from treatment with vasoactive medication after fluid resuscitative therapy.
File