Is it possible to obtain Frank–Starling curves in the intensive care unit?

Introduction

Oxygen delivery depends on cardiac output and oxygen arterial content. Adequate preload is important to optimize cardiac output. Optimal preload can be obtained through Frank–Starling curves, which are difficult to determine at the bedside. Thus, optimal preload is difficult to determine in the intensive care unit.

Objective

To evaluate the correlation between the wedge pressure and systolic volume in different subsets of shock.

Materials and methods

This study was undertaken in a general intensive care unit and enrolled 41 patients, with 334 hemodynamic measures in sepsis (139), in cardiogenic shock (119) and in hepatic transplantation (76) in the period from January to November 2002.

Results

See Figure 1.

Figure 1

R, Pearson correlation coefficient; R², square Pearson correlation coefficient.

Conclusion

A higher wedge pressure is not associated with a greater systolic volume. Thus, the absolute value of the wedge pressure cannot be associated with optimal preload.