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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học quốc tế cung cấp cho các bạn kiến thức về ngành y đề tài: Pulse pressure variation and volume responsiveness during acutely increased pulmonary artery pressure: an experimental study. | Daudel et al. Critical Care 2010 14 R122 http ccforum.eom content 14 3 R122 c CRITICAL CARE RESEARCH Open Access Pulse pressure variation and volume responsiveness during acutely increased pulmonary artery pressure an experimental study Fritz Daudelt David Tuller Stefanie Krahenbuhl Stephan M Jakob Jukka Takala Abstract Introduction We found that pulse pressure variation PPV did not predict volume responsiveness in patients with increased pulmonary artery pressure. This study tests the hypothesis that PPV does not predict fluid responsiveness during an endotoxin-induced acute increase in pulmonary artery pressure and right ventricular loading. Methods Pigs were subjected to endotoxemia 0.4 pg kg hour lipopolysaccharide followed by volume expansion subsequent hemorrhage 20 of estimated blood volume retransfusion and additional stepwise volume loading until cardiac output did not increase further n 5 . A separate control group n 7 was subjected to bleeding retransfusion and volume expansion without endotoxemia. Systemic hemodynamics were measured at baseline and after each intervention and PPV was calculated offline. Prediction of fluid-challenge-induced stroke volume increase by PPV was analyzed using receiver operating characteristic ROC curves. Results Sixty-eight volume challenges were performed in endotoxemic animals 22 before and 46 after hemorrhage and 51 volume challenges in the controls. Endotoxin infusion resulted in an acute increase in pulmonary artery and central venous pressure and a decrease in stroke volume all P 0.05 . In endotoxemia 68 of volume challenges before hemorrhage increased the stroke volume by 10 but PPV did not predict fluid responsiveness area under the ROC curve 0.604 P 0.461 . After hemorrhage in endotoxemia stroke volume increased in 48 and the predictive value of PPV improved area under the ROC curve for PPV 0.699 P 0.021 . In controls after hemorrhage stroke volume increased in 67 of volume challenges and PPV was a predictor of .
