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Published in: Intensive Care Medicine 8/2008

01-08-2008 | Experimental

Systolic pressure variation and pulse pressure variation during modifications of arterial pressure

Authors: Jens C. Kubitz, Stefanie Forkl, Thorsten Annecke, Nils Kronas, Alwin E. Goetz, Daniel A. Reuter

Published in: Intensive Care Medicine | Issue 8/2008

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Abstract

Objective

This study was performed to investigate the effect of vasopressor therapy on systolic pressure variation (SPV) and pulse pressure variation (PPV) compared to experimentally measured left ventricular stroke volume variation (SVV).

Design and setting

Prospective study in a university laboratory.

Subjects

Twelve anesthetized and mechanically ventilated pigs.

Interventions

Increase in mean arterial pressure (by 100%) using phenylephrine and decrease (by 38%) using adenosine.

Measurements and results

SPV and PPV were calculated and compared to SVV derived from aortic blood flow measurements. SPV was significantly affected by changes in arterial pressure [4.6% (1.5) vs. 6.3% (2.1), p < 0.05, increased vs. decreased arterial pressure], whereas PPV did not change during modifications of arterial pressure. During baseline conditions and decreased afterload, correlation with SVV was good both for SPV (r = 0.892 and r = 0.859, respectively) and for PPV (r = 0.870 and r = 0.871, respectively) (all p < 0.001). Correlation with SVV was only moderate during increased arterial pressure (r = 0.683 for SPV and r = 0.732 for PPV, p < 0.05).

Conclusion

For guiding fluid therapy in patients under vasopressor support, PPV seems superior to SPV.
Literature
1.
go back to reference Michard F, Teboul JL (2002) Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest 121:2000–2008PubMedCrossRef Michard F, Teboul JL (2002) Predicting fluid responsiveness in ICU patients: a critical analysis of the evidence. Chest 121:2000–2008PubMedCrossRef
2.
go back to reference Pinsky MR (2005) Assessment of indices of preload and volume responsiveness. Curr Opin Crit Care 11:235–239PubMedCrossRef Pinsky MR (2005) Assessment of indices of preload and volume responsiveness. Curr Opin Crit Care 11:235–239PubMedCrossRef
3.
go back to reference Kubitz JC, Annecke T, Forkl S, Kemming GI, Kronas N, Goetz AE, Reuter DA (2007) Validation of pulse contour derived stroke volume variation during modifications of cardiac afterload. Br J Anaesth 98:591–597PubMedCrossRef Kubitz JC, Annecke T, Forkl S, Kemming GI, Kronas N, Goetz AE, Reuter DA (2007) Validation of pulse contour derived stroke volume variation during modifications of cardiac afterload. Br J Anaesth 98:591–597PubMedCrossRef
4.
go back to reference Critchley LAH, Critchley JAJH (1999) A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J Clin Monit 15:85–91CrossRef Critchley LAH, Critchley JAJH (1999) A meta-analysis of studies using bias and precision statistics to compare cardiac output measurement techniques. J Clin Monit 15:85–91CrossRef
5.
go back to reference Pinsky MR (2005) The dynamic interface between hemodynamic variables and autonomic tone. Crit Care Med 33:2437–2438PubMedCrossRef Pinsky MR (2005) The dynamic interface between hemodynamic variables and autonomic tone. Crit Care Med 33:2437–2438PubMedCrossRef
6.
go back to reference Nouira S, Elatrous S, Dimassi S, Besbes L, Boukef R, Mohamed B, Abroug F (2005) Effects of norepinephrine on static and dynamic preload indicators in experimental hemorrhagic shock. Crit Care Med 33:2339–2343PubMedCrossRef Nouira S, Elatrous S, Dimassi S, Besbes L, Boukef R, Mohamed B, Abroug F (2005) Effects of norepinephrine on static and dynamic preload indicators in experimental hemorrhagic shock. Crit Care Med 33:2339–2343PubMedCrossRef
7.
go back to reference Tavernier B, Makhotine O, Lebuffe G, Dupont J, Scherpereel P (1998) Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology 89:1313–1321PubMedCrossRef Tavernier B, Makhotine O, Lebuffe G, Dupont J, Scherpereel P (1998) Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology 89:1313–1321PubMedCrossRef
8.
go back to reference Michard F, Boussat S, Chemla D, Anguel N, Mercat A, Lecarpentier Y, Richard C, Pinsky MR, Teboul JL (2000) Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 162:134–138PubMed Michard F, Boussat S, Chemla D, Anguel N, Mercat A, Lecarpentier Y, Richard C, Pinsky MR, Teboul JL (2000) Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 162:134–138PubMed
9.
go back to reference McDonald DA (1960) Blood flow in arteries. Edward Arnold, London McDonald DA (1960) Blood flow in arteries. Edward Arnold, London
Metadata
Title
Systolic pressure variation and pulse pressure variation during modifications of arterial pressure
Authors
Jens C. Kubitz
Stefanie Forkl
Thorsten Annecke
Nils Kronas
Alwin E. Goetz
Daniel A. Reuter
Publication date
01-08-2008
Publisher
Springer-Verlag
Published in
Intensive Care Medicine / Issue 8/2008
Print ISSN: 0342-4642
Electronic ISSN: 1432-1238
DOI
https://doi.org/10.1007/s00134-008-1114-8

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