Critical Care Cardiology in the Perioperative Period by J. L. Atlee (auth.), J. L. Atlee, J.-L. Vincent (eds.)

By J. L. Atlee (auth.), J. L. Atlee, J.-L. Vincent (eds.)

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An example of this type of sophisticated control is the recording of left ventricular pressure/volume curves. It would seem obvious that the use of sophisticated systems such as those described above permits the physician to obtain the best performance in terms of diagnosis and therapy. However, this has not yet been proven. 32 B. Allaria, M. Dei Poli, F. D'Elia, M. Favaro A study conducted at the University of Bonn and published less than a year ago [ 1] examined the behavior of 20 anesthesiologists of varying levels of experience in the face of a hemodynamic situation which was presented in three ways: (1) trends, (2) profilograms and (3) ecological interface.

Van Woerkens EC, Trouwborst A, Van Lanschot JJ (1992) Profound hemodilution: what is the critical level of hemodilution at which oxygen delivery-dependent oxygen consumption starts in an anesthetized human? Anesth Analg 75:818-821 How to Interpret Cardiac Output and Haemodynamic Indexes 27 J et al (1998) Human cardiovascular and metabolic response to acute, severe isovolemic anemia. JAMA 279:217-221 23. Yalavatti GS, De Backer D, Vincent JL (2000) Assessment of cardiac index in anemic patients.

The cardiac output must therefore be interpreted in relation to the haemoglobin value. A recent study by Yalavatti et a!. [23] used the relationship between cardiac index and 0 2 ER to assess the adequacy of cardiac index during anaemia. This relationship, which is easily obtained and viewed at the bedside, is independent of the haemoglobin level, which thus becomes an independent variable. These authors selected a cardiac index to 0 2ER ratio of 10 to assess the adequacy of the cardiac index. Hence a value greater than 10 would show an adequate cardiac response, while a figure less than 10 would suggest insufficient cardiac compensation, with a proportionately greater increase in 0 2ER than in cardiac index.

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