Influence of Positive End-Expiratory Pressure on Myocardial Strain Assessed by Speckle Tracking Echocardiography in Mechanically Ventilated Patients

被引：33

作者：

Franchi, Federico ^{[1
]}

Faltoni, Agnese ^{[1
]}

Cameli, Matteo ^{[2
]}

Muzzi, Luigi ^{[1
]}

Lisi, Matteo ^{[2
]}

Cubattoli, Lucia ^{[1
]}

Cecchini, Sofia ^{[1
]}

Mondillo, Sergio ^{[2
]}

Biagioli, Bonizella ^{[1
]}

Taccone, Fabio Silvio ^{[3
]}

Scolletta, Sabino ^{[1
]}

机构：

[1] Univ Siena, Dept Med Biotechnol, Unit Intens Care Med, I-53100 Siena, Italy

[2] Univ Siena, Unit Cardiol, Dept Med Biotechnol, I-53100 Siena, Italy

[3] Erasme Univ Hosp, Dept Intens Care, B-1070 Brussels, Belgium

来源：

BIOMED RESEARCH INTERNATIONAL | 2013年 / 2013卷

关键词：

CRITICALLY-ILL PATIENTS; RIGHT-VENTRICULAR FUNCTION; CARDIAC-OUTPUT; LONGITUDINAL STRAIN; AMERICAN-SOCIETY; TRANSTHORACIC ECHOCARDIOGRAPHY; 2-DIMENSIONAL STRAIN; EUROPEAN-ASSOCIATION; STANDARDS COMMITTEE; ARTERIAL-PRESSURE;

D O I：

10.1155/2013/918548

中图分类号：

Q81 [生物工程学（生物技术）]; Q93 [微生物学];

学科分类号：

071005 ; 0836 ; 090102 ; 100705 ;

摘要：

Purpose. The effects of mechanical ventilation (MV) on speckle tracking echocardiography- (STE-)derived variables are not elucidated. The aim of the study was to evaluate the effects of positive end-expiratory pressure (PEEP) ventilation on 4-chamber longitudinal strain (LS) analysis by STE. Methods. We studied 20 patients admitted to a mixed intensive care unit who required intubation for MV and PEEP titration due to hypoxia. STE was performed at three times: (T1) PEEP = 5cmH(2)O; (T2) PEEP = 10cmH(2)O; and (T3) PEEP = 15cmH(2)O. STE analysis was performed offline using a dedicated software (XStrain MyLab 70 Xvision, Esaote). Results. Left peak atrial-longitudinal strain (LS) was significantly reduced from T1 to T2 and from T2 to T3 (P < 0.05). Right peak atrial-LS and right ventricular-LS showed a significant reduction only at T3 (P < 0.05). Left ventricular-LS did not change significantly during titration of PEEP. Cardiac chambers' volumes showed a significant reduction at higher levels of PEEP (P < 0.05). Conclusions. We demonstrated for the first time that incremental PEEP affects myocardial strain values obtained with STE in intubated critically ill patients. Whenever performing STE in mechanically ventilated patients, care must be taken when PEEP is higher than 10 cmH(2)O to avoid misinterpreting data and making erroneous decisions.

引用

页数：8

共 42 条

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