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Intensive Care Med (2014) 40:139DOI 10.1007/s00134-013-3089-3 CORRESPONDENCE
Geoffrey Parkin
Re: Mean systemic lling pressure: we can now estimate it but for what?
Accepted: 26 August 2013Published online: 11 September 2013 Springer-Verlag Berlin Heidelberg and
ESICM 2013
Dear Editor,It is a pleasure to respond, as author of the Pms algorithm to which his editorial refers, to Prof. Tebouls provocative title [1].
Refreshingly, we see acceptance of Pms, rather than any preload measure, as the preferred method of evaluating the effective blood volume, denitely a step in the right direction.
So why does Teboul invite such a bleak reply? Why is a Guytonian approach to the circulation only now nding its way into mainstream care?
One answer, we agree, is that Pms is not easy to measure repeatedly using inspiratory hold or arm compression [2]. We have demonstrated [3] that a useful Pms analogue, Pmsa, can be calculated using
Pmsa 0:96 RAP 0:04
MAP c CO 1 where c is an anthropometrically based variable (0.3 \ c \ 1.2) with the...