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2025, Number 2

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Med Crit 2025; 39 (2)

Ventriculo-arterial coupling-based hemodynamic optimization: review of concepts and clinical applications

Turrubiates HTA, Mora MGM, Reyes PAA, Soberano BRU, Soto HGA

Language: Spanish
References: 23
Page: 130-137
PDF size: 463.28 Kb.


ABSTRACT

Acute circulatory dysfunction is a common cause of admission to the ICU and is associated with inadequate oxygen utilization at the cellular level. Hemodynamic monitoring helps guide treatment and improve outcomes. Arterial load (AL) represents the resistance that the ventricle must overcome during ejection and can be assessed through arterial impedance (Z); these characteristics can be represented by arterial elastance (Ea). Ventriculo-arterial coupling (VAC) evaluates the interaction between Ea and ventricular elastance (Ev), optimizing cardiac efficiency. VAC is altered in different types of shock (e.g., cardiogenic, septic), where the balance between Ev and Ea is lost. Measuring VAC allows for personalized treatment, improving outcomes in critically ill patients. Incorporating this parameter facilitates more precise clinical decisions, optimizes resource use, and reduces costs in managing hemodynamic instability.


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