Unveiling the Significance of Dynamic Arterial Elastance: An Insightful Approach to Assessing Arterial Load in an Endotoxin Shock Model
Jorge I. Alvarado Sánchez, Juan D. Caicedo Ruiz, Juan J. Diaztagle Fernández, Manuel I. Monge Garcia, Luis E. Cruz Martínez- Critical Care and Intensive Care Medicine
- Emergency Medicine
Abstract
Background
The aim of this study was to investigate the relationship between dynamic arterial elastance (EaDyn) and the pulsatile and steady components of arterial load in an endotoxin shock model using a two-element Windkessel model and to describe the behavior of EaDyn in this model.
Methods
Ten female Yorkshire pigs were administered lipopolysaccharide intravenously to induce endotoxin shock, while three female pigs served as the control group. Measurements of EaDyn (ratio between pulse pressure variation (PPV) and stroke volume variation (SVV)), effective arterial elastance, arterial compliance (Cart), and systemic vascular resistance were taken every 30 minutes in the endotoxin group until shock was induced. In the control group, these variables were measured every 30 minutes for 3 hours. Subsequently, a fluid load was administered to both groups, and measurements were repeated every 30 minutes. After one hour of shock induction, the endotoxin group was divided into two subgroups: one receiving norepinephrine (END-NE) and the other not receiving it (END-F).
Results
EaDyn showed an association with Cart, while PPV was connected to both pulsatile and steady components, and SVV was solely associated with steady components. Additionally, EaDyn exhibited higher values in the END groups than in the control group when shock was achieved. Furthermore, after the administration of norepinephrine, EaDyn displayed higher values in END-F than in END-NE.
Conclusions
The EaDyn variable helps identify changes in the pulsatile component of arterial load, providing valuable guidance for management strategies aimed at improving cardiac performance.