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Related Concept Videos

Measurement of Blood Pressure01:17

Measurement of Blood Pressure

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Assessing blood pressure is a standard procedure executed in virtually all medical environments. The method utilized today was established over a hundred years ago by an innovative Russian doctor, Dr. Nikolai Korotkoff. The soft ticking noise, known as Korotkoff sounds, heard while taking blood pressure readings results from turbulent blood flow within the vessels. The apparatus required for this procedure includes a sphygmomanometer, a blood pressure cuff attached to a gauge, and a...
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Blood Pressure01:24

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The movement of blood in a human body, commonly referred to as blood flow, is determined by the volume of blood that traverses a certain section of the bodily system per unit time. It is the rhythmic contraction of the heart's ventricles that primarily instigates this movement. As the ventricles contract, blood is forced into the prominent arteries, which then flow from areas of greater pressure to lower pressure areas. This movement continues into smaller arteries and arterioles and...
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Peripheral Arterial Disease II: Clinical Manifestations and Diagnostic Evaluation01:21

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Clinical manifestationsPeripheral Arterial Disease (PAD) manifests through a range of symptoms, from the characteristic intermittent claudication to atypical presentations and severe complications in advanced stages. Intermittent claudication, a hallmark symptom of PAD, presents as exercise-induced muscle pain that typically resolves within minutes of rest. This pain is reproducible and stems from inadequate blood flow, leading to the accumulation of lactic acid produced during anaerobic...
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Heart Failure II: Pathophysiology01:29

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Systolic Heart Failure and Compensatory MechanismsSystolic heart failure (also termed HFrEF, Heart Failure with Reduced Ejection Fraction) is the most prevalent type of heart filure. It results in a decreased volume of blood being pumped from the ventricle. The aortic arch and carotid sinuses have baroreceptors that detect reduced blood pressure, triggering the sympathetic nervous system (SNS) to release epinephrine and norepinephrine. Initially, this response aims to boost heart rate and...
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Special considerations while measuring blood pressure01:28

Special considerations while measuring blood pressure

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When assessing blood pressure (BP), healthcare professionals must consider various factors and potential unexpected outcomes to ensure accurate readings and provide proper patient care. Adhering to these guidelines is essential to achieving the most reliable results.
Monitoring Both Arms:
Monitoring BP in both arms during the initial assessment is advisable, as the systolic value may differ by five to ten mm Hg between arms. For subsequent BP assessments, use the arm with the higher reading.
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Correction: Yalçın et al. Impact of SGLT2 Inhibitors on Cardiovascular Risk Scores, Metabolic Parameters, and Laboratory Profiles in Type 2 Diabetes. <i>Life</i> 2025, <i>15</i>, 722.

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Updated: Aug 13, 2025

Echocardiographic Assessment Using Subxiphoid-Only Examination for Hypotensive Patients
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Dynamic Arterial Elastance to Predict Mean Arterial Pressure Decrease after Reduction of Vasopressor in Septic Shock

Paolo Persona1, Tommaso Tonetti2,3, Ilaria Valeri1

  • 1Institute of Anaesthesia and Intensive Care, Padua University Hospital, 35128 Padua, Italy.

Life (Basel, Switzerland)
|January 21, 2023
PubMed
Summary
This summary is machine-generated.

Dynamic elastance (EaDyn) can predict dangerous drops in mean arterial pressure (MAP) after reducing norepinephrine in septic shock patients. This noninvasive measure helps guide vasopressor de-escalation safely.

Keywords:
PPV/SVVdynamic elastancehaemodynamic monitoringseptic shock

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Area of Science:

  • Critical Care Medicine
  • Hemodynamics
  • Septic Shock Management

Background:

  • Norepinephrine is crucial for treating septic shock after fluid optimization.
  • Reducing vasopressors carries mortality risks due to potential hypotension.
  • Predictive tools are needed to guide safe vasopressor de-escalation.

Purpose of the Study:

  • To evaluate dynamic elastance (EaDyn) as a noninvasive predictor of mean arterial pressure (MAP) drop after norepinephrine reduction in septic shock.
  • To assess the accuracy of EaDyn in identifying patients at risk for significant hypotension following vasopressor de-escalation.

Main Methods:

  • Prospective observational study of 42 septic shock patients.
  • Measured EaDyn noninvasively using the MostCare monitoring system.
  • Assessed MAP changes 30 minutes after norepinephrine reduction.
  • Categorized patients into responders (MAP drop > 10%) and non-responders (MAP drop < 10%).

Main Results:

  • EaDyn demonstrated an area under the curve of 0.84 in predicting a MAP drop > 10%.
  • An EaDyn cut-off of 0.84 showed 71% sensitivity and 89% specificity for predicting MAP decrease.
  • Multivariate logistic regression confirmed EaDyn's independent association with MAP decrease (OR 0.001, p < 0.001).

Conclusions:

  • Dynamic elastance (EaDyn) is a reliable, noninvasive predictor of significant MAP drops after norepinephrine reduction in septic shock.
  • EaDyn can aid clinicians in making safer decisions regarding vasopressor de-escalation, potentially reducing mortality risk.