Document Detail

Influence of Pressure Control Levels on the Pulse Pressure Variations: an Animal Study Using Healthy Piglets.
MedLine Citation:
PMID:  21921829     Owner:  NLM     Status:  Publisher    
BACKGROUND:: Pulse pressure variation (PPV) is a promising predictor for volume responsiveness. However, recent studies have criticized its validity during small tidal volume ventilation. The present study evaluated the influence of pressure control level (PCL) on PPV. METHODS:: Six anesthetized healthy piglets simulating hemorrhagic shock underwent 5 stages of intravascular volume status change. Each stage comprised of 4 cycles of PCL manipulation. In each cycle, five different PCL were applied in random order. RESULTS:: Among 600 arterial pressure tracings obtained during PCL manipulations, 26 tracings were excluded due to signal artifact or ectopic beats. For the remaining 574 tracings, the percentage of normal beats among total recorded beats in each tracing was 99.80±0.85%. When manipulating PCL causing an abrupt change within -16 ~ +8 cmH2O, the PPV responded rapidly and stabilized within 60 seconds following manipulation. With higher increment in PCL (+12 ~ +16 cmH2O), it required 90 seconds for PPV to stabilize. Under each cycle of PCL manipulation, the PPV are linearly correlated to the PCL (r-square = 0.84±0.21) and tidal volume (r-square = 0.83±0.22). The PPV as well as the slopes of the trend lines decreased from hypovolemic stages toward hypervolemic stages. CONCLUSIONS:: PPV responds rapidly to change in ventilator setting and is linearly correlated with the PCL and tidal volume. These characteristics may have important applications in critical care to improve the interpretation of PPV in accord to different ventilator settings.
Chih-Hsin Lee; Yao-Kuang Wu; Jann-Yuan Wang; Chou-Chin Lan; Chun-Yi Lee; Kuei-Yao Hsu; Kun-Mao Chao; Hung Chang
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2011-9-3
Journal Detail:
Title:  Shock (Augusta, Ga.)     Volume:  -     ISSN:  1540-0514     ISO Abbreviation:  -     Publication Date:  2011 Sep 
Date Detail:
Created Date:  2011-9-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9421564     Medline TA:  Shock     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Graduate Institute of Biomedical Electronics and Bioinformatics1, National Taiwan University, Taiwan; Departments of Internal Medicine2 and Anesthesiology3, Buddhist Tzu Chi General Hospital, Taipei Branch, Taipei, Taiwan; School of Medicine4, Tzu Chi University, Hualien, Taiwan; Department of Internal Medicine5, Taiwan University Hospital, Taipei, Taiwan; Graduate Institute of Physiology6, National Defense Medical Center, Taipei, Taiwan; Department of Surgery7, Tri-Service General Hospital, Taipei, Taiwan.
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