Related Experiment Video
Updated: Dec 23, 2025
09:31
Hemodynamic Precision in the Neonatal Intensive Care Unit using Targeted Neonatal Echocardiography
Published on: January 27, 2023
1.4K
How to assess ventriculoarterial coupling in sepsis
Michael R Pinsky1, Fabio Guarracino2
1Department of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania, USA.
Current Opinion in Critical Care
|April 30, 2020
Summary
Ventriculoarterial coupling, crucial in sepsis, assesses heart-artery function. Decoupling indicates poor outcomes, but monitoring aids resuscitation and improves patient survival.
Area of Science:
- Cardiovascular Physiology
- Critical Care Medicine
- Hemodynamics
Background:
- Sepsis frequently presents with ventriculoarterial (VA) uncoupling, where arterial elastance (Ea) exceeds left ventricular (LV) end-systolic elastance (Ees).
- This imbalance often occurs despite arterial hypotension and impacts patient prognosis.
Purpose of the Study:
- To elucidate the role of VA coupling in sepsis pathophysiology.
- To describe methods for assessing VA coupling at the bedside.
Main Methods:
- Quantification of VA coupling using the ratio of Ea to Ees.
- Utilizing noninvasive echocardiography combined with arterial pressure monitoring for bedside estimation of Ea and Ees.
Main Results:
- Optimal cardiovascular efficiency occurs when Ea/Ees is near 1.
- Ea/Ees > 1 (decoupling) signifies decreased cardiac efficiency, heart failure, and reduced volume responsiveness.
- VA coupling status predicts cardiovascular response to resuscitation and patient outcomes.
Conclusions:
- VA coupling is a key determinant of the initial cardiovascular state in sepsis.
- Sequential bedside monitoring of VA coupling provides critical insights for guiding resuscitation efforts.
- Assessing and managing VA coupling can improve outcomes in critically ill septic patients.
Related Concept Videos
01:26Imbalances in Cardiac Output
2.1K
The heart's primary function is to pump blood throughout the body, maintaining a balance between blood sent out (cardiac output) and blood returning (venous return). If this balance is disrupted, it can result in congestive heart failure (CHF), a severe condition where the heart becomes an inefficient pump, leading to inadequate blood circulation.
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
CHF can occur due to the failure of either side of the heart. Left-side failure leads to pulmonary congestion—the right side continues to send...
2.1K
01:25Assessment of apical radial pulse
1.1K
Apical-Radial (A-R) Pulse Assessment
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
The A-R pulse assessment involves simultaneous evaluation of the apical and radial pulses. When the apical and radial pulse rates vary, this assessment helps identify a pulse deficit.
Pre-Procedural Preparation
1.1K
01:25Assessment of the Cardiovascular System IV: Auscultation
1.5K
Cardiac auscultation is a clinical skill used to assess heart function and detect abnormalities. It involves listening to heart sounds at specific anatomical locations through a stethoscope.
Normal Heart Sounds
S1 (First Heart Sound)-
S1 is made by the closure of the mitral and tricuspid valves (atrioventricular valves), marking the beginning of systole.
S2 (Second Heart Sound)-
S2 is made by the closure of the aortic and pulmonic valves (semilunar valves), marking the end of the systole.
Normal Heart Sounds
S1 (First Heart Sound)-
S1 is made by the closure of the mitral and tricuspid valves (atrioventricular valves), marking the beginning of systole.
S2 (Second Heart Sound)-
S2 is made by the closure of the aortic and pulmonic valves (semilunar valves), marking the end of the systole.
1.5K
01:25Cardiovascular System Abnormal Findings II: Auscultation
453
Auscultation, an essential part of a heart examination, is done using a stethoscope. It provides crucial information about heart function and possible heart problems. Due to heart problems, abnormal sounds can be heard during systole or diastole. These sounds include S3 and S4 gallops, opening snaps, systolic clicks, and murmurs.
Abnormal Heart Sounds
Gallops:
Abnormal Heart Sounds
Gallops:
453
01:15Aortic Regurgitation I: Introduction
334
IntroductionAortic regurgitation is characterized by the backward flow of blood from the aorta into the left ventricle during diastole and arises from the improper closure of the aortic valve. This condition results in left ventricular volume overload and can stem from both acute and chronic etiologies, each contributing uniquely to the disease's progression and symptomatology.Acute and Chronic CausesAcute aortic regurgitation often results from events that suddenly impair the integrity of the...
334
01:20Assessment of Ventilation I: Respiratory Rate
1.8K
Assessment of Ventilation
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
A Ventilation assessment is critical for monitoring a patient's health status. Respiration, one of the most accessible vital signs, provides insights into the function of numerous body systems and can indicate serious health issues, such as brainstem injuries from head trauma.
Critical Guidelines for Assessing Ventilation:
1.8K