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Background  Peak first derivative of femoral artery pressure (arterial dP/dt max ) derived from fluid-filled catheter remains questionable to assess left ventricular (LV) contractility during shock. The aim of this study was to test if arterial dP/dt max  is reliable for assessing LV contractility during various hemodynamic conditions such as endotoxin-induced shock and catecholamine infusion.    Methods  Ventricular pressure-volume data obtained with a conductance catheter and invasive arterial pressure obtained with a fluid-filled catheter were continuously recorded in 6 anaesthetized and mechanically ventilated pigs. After a stabilization period, endotoxin was infused to induce shock. Catecholamines were transiently administrated during shock. Arterial dP/dt max  was compared to end-systolic elastance (Ees), the gold standard method for assessing LV contractility.    Results  Endotoxin-induced shock and catecholamine infusion lead to significant variations in LV contractility. Overall, significant correlation (r = 0.51;  p  < 0.001) but low agreement between the two methods were observed. However, a far better correlation with a good agreement were observed when positive-pressure ventilation induced an arterial pulse pressure variation (PPV) ≤ 11% (r = 0.77;  p  < 0.001).    Conclusion  While arterial dP/dt max  and Ees were significantly correlated during various hemodynamic conditions, arterial dP/dt max  was more accurate for assessing LV contractility when adequate vascular filling, defined as PPV ≤ 11%, was achieved.

Arterial dP/dtmax accurately reflects left ventricular contractility during shock when adequate vascular filling is achieved