Ventriculo-Arterial Coupling in Critical Care Patients

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.