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Bedside assessment of mean systemic filling pressure

Jansen, JRC and Maas, JJ and Pinsky, MR (2010) Bedside assessment of mean systemic filling pressure. Current Opinion in Critical Care, 16 (3). 231 - 236. ISSN 1070-5295

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Abstract

PURPOSE OF REVIEW: The physiology of the venous part of the human circulation seems to be a forgotten component of the circulation in critical care medicine. One of the main reasons, probably, is that measures of right atrial pressure (Pra) do not seem to be directly linked to blood flow. This perception is primarily due to an inability to measure the pressure gradient for venous return. The upstream pressure for venous return is mean systemic filling pressure (Pmsf) and it does not lend itself easily to be measured. Recent clinical studies now demonstrate the basic principles underpinning the measure of Pmsf at the bedside. RECENT FINDINGS: Using routinely available minimally invasive monitoring of continuous cardiac output and Pra, one can accurately construct venous return curves by performing a series of end-inspiratory hold maneuvers, in ventilator-dependent patients. From these venous return curves, the clinician can now finally obtain at the bedside not only Pmsf but also the derived parameters: resistance to venous return, systemic compliance and stressed volume. SUMMARY: Measurement of Pmsf is essential to describe the control of vascular capacitance. It is the key to distinguish between passive and active mechanisms of blood volume redistribution and partitioning total blood volume in stressed and unstressed volume. © 2010 Wolters Kluwer Health | Lippincott Williams & Wilkins.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Jansen, JRC
Maas, JJ
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 1 June 2010
Date Type: Publication
Journal or Publication Title: Current Opinion in Critical Care
Volume: 16
Number: 3
Page Range: 231 - 236
DOI or Unique Handle: 10.1097/mcc.0b013e3283378185
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 1070-5295
Article Type: Review
PubMed ID: 20168223
Date Deposited: 05 Jul 2012 22:05
Last Modified: 30 Jan 2020 16:56
URI: http://d-scholarship.pitt.edu/id/eprint/12569

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