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A pilot study of the epidemiology and associations of pulse pressure variation in cardiac surgery patients.
MedLine Citation:
PMID:  21355824     Owner:  NLM     Status:  In-Data-Review    
Abstract/OtherAbstract:
BACKGROUND: Pulse pressure variation (PPV) is an accepted measure of intravascular filling. It can now be estimated automatically. However, there is limited knowledge of the epidemiology and associations of such estimates in cardiac surgery patients.
METHODS: We conducted a pilot prospective observational study of the epidemiology and associations of automatically estimated PPV in 30 cardiac surgery patients admitted to the intensive care unit of a tertiary hospital. The study was conducted in June and July 2010. We collected automated monitor-estimated PPV values every 15 minutes during mandatory ventilation in patients after cardiac surgery. We simultaneously collected data on all relevant haemodynamic values, hourly fluid balance, tidal volume (V(T)) and peak airway pressure. We made a total of 205 measurements on 30 patients. A PPV value ≥13% was selected as defining a likely fluid responsiveness (FR) state. Clinicians were not informed of the study.
RESULTS: PPV values ≥13% were present in 38% of measurements, and the average duration of this physiological state was 38 minutes per patient. Higher PPV values correlated with negative fluid balance (P < 0.001), lower mean pulmonary arterial pressure (P = 0.018), lower cardiac index (P = 0.013), higher peak airway pressure (P < 0.001) and higher V(T) (P < 0.001).
CONCLUSIONS: In a tertiary ICU, among patients who had recently had cardiac surgery, automated PPV values in the likely FR range were present in over a third of measurements. Correlations with other haemodynamic and ventilation values were logical and expected.
Authors:
In Byung Kim; Rinaldo Bellomo; Nigel Fealy; Ian Baldwin
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Critical care and resuscitation : journal of the Australasian Academy of Critical Care Medicine     Volume:  13     ISSN:  1441-2772     ISO Abbreviation:  Crit Care Resusc     Publication Date:  2011 Mar 
Date Detail:
Created Date:  2011-03-01     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  100888170     Medline TA:  Crit Care Resusc     Country:  Australia    
Other Details:
Languages:  eng     Pagination:  17-23     Citation Subset:  IM    
Affiliation:
Department of Emergency Medicine, Kwan Dong University, Seoul, Korea. rinaldo.bellomo@austin.org.au.
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