title: Left ventricular end-diastolic area is a measure of cardiac preload in patients with early septic shock.
abstract: OBJECTIVE
  Central venous pressure, intrathoracic blood volume, and left ventricular end-diastolic area are reliable measures of cardiac preload under stable clinical conditions. The purpose of this study was to compare different preload parameters over 24 h under conditions of multiple, frequently changing treatments in early septic shock.
  
  
  METHODS
  In 28 mechanically ventilated patients within 6 h of the onset of septic shock, left ventricular end-diastolic area was measured using transoesophageal echocardiography. Intrathoracic blood volume, stroke volume variation, and central venous pressure were analysed as preload parameters. The relation between parameter changes and changes in therapy was examined with respect to cardiac index and stroke volume index.
  
  
  RESULTS
  Regarding preload variables, linear regression analyses revealed a significant correlation between left ventricular end-diastolic area and stroke volume index (r=0.59, P<0.001) and cardiac index (r=0.41, P<0.001), respectively. Changes in left ventricular end-diastolic index and intrathoracic blood volume index reflected changes in the stroke volume index, whereas central venous pressure did not. Myocardial responsiveness also failed to predict changes in the stroke volume index.
  
  
  CONCLUSIONS
  Only the left ventricular end-diastolic area index may help predict preload in ventilated patients with early septic shock.
authors.affiliation: Department of Anaesthesiology, University of Heidelberg, Heidelberg, Germany.
authors.forename: Karoline
authors.initials: K
authors.lastname: Scheuren
authors.forename: Moritz N
authors.initials: MN
authors.lastname: Wente
authors.forename: Christian
authors.initials: C
authors.lastname: Hainer
authors.forename: Matthias
authors.initials: M
authors.lastname: Scheffler
authors.forename: Christoph
authors.initials: C
authors.lastname: Lichtenstern
authors.forename: Eike
authors.initials: E
authors.lastname: Martin
authors.forename: Jan
authors.initials: J
authors.lastname: Schmidt
authors.forename: Christian
authors.initials: C
authors.lastname: Bopp
authors.forename: Markus A
authors.initials: MA
authors.lastname: Weigand
mesh_terms: D002302:Cardiac Output / Q000502:physiology*; D002496:Central Venous Pressure / Q000502:physiology; D017548:Echocardiography, Transesophageal; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009200:Myocardial Contraction; D012044:Regression Analysis; D012121:Respiration, Artificial; D012772:Shock, Septic / Q000503:physiopathology* / Q000628:therapy; D013318:Stroke Volume / Q000502:physiology; D016896:Treatment Outcome; D016277:Ventricular Function, Left / Q000502:physiology*