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Pulse pressure is calculated as the difference between the systolic blood pressure and the diastolic blood pressure. [3] [4]The systemic pulse pressure is approximately proportional to stroke volume, or the amount of blood ejected from the left ventricle during systole (pump action) and inversely proportional to the compliance (similar to elasticity) of the aorta.
Diastolic blood pressure falls during the early stages of sepsis, causing a widening/increasing of pulse pressure, which is the difference between the systolic and diastolic blood pressures. If sepsis becomes severe and hemodynamic compromise advances, the systolic pressure also decreases, causing a narrowing/decreasing of pulse pressure. [23]
Pulse pressure can both widen or narrow in people with sepsis depending on the degree of hemodynamic compromise. A pulse pressure of over 70 mmHg in sepsis is correlated with an increased chance of survival and a more positive response to IV fluids. [94] [95]
Dopamine may cause rapid heart rate and arrhythmias, and is only recommended in combination with norepinephrine in those with slow heart rate and low risk of arrhythmia. In the initial treatment of low blood pressure in septic shock, the goal of vasopressor treatment is a mean arterial pressure (MAP) of 65 mm Hg. [10]
With the formula to achieve objectives, called Goal-Directed Therapy (GDT), Rivers (2001) demonstrated how to reduce mortality in patients with severe sepsis and septic shock through the optimization of different hemodynamic variables for a dynamic and individualized view, instead of maintaining only an adequate Arterial Pressure (AP).
Hyperdynamic circulation is abnormally increased circulatory volume. Systemic vasodilation and the associated decrease in peripheral vascular resistance results in decreased pulmonary capillary wedge pressure and decreased blood pressure, presenting usually with a collapsing pulse, but sometimes a bounding pulse.
Major factors influencing cardiac output – heart rate and stroke volume, both of which are variable. [1]In cardiac physiology, cardiac output (CO), also known as heart output and often denoted by the symbols , ˙, or ˙, [2] is the volumetric flow rate of the heart's pumping output: that is, the volume of blood being pumped by a single ventricle of the heart, per unit time (usually measured ...
In medicine, the mean arterial pressure (MAP) is an average calculated blood pressure in an individual during a single cardiac cycle. [1] Although methods of estimating MAP vary, a common calculation is to take one-third of the pulse pressure (the difference between the systolic and diastolic pressures), and add that amount to the diastolic pressure.