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Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Pulse pressure variation: beyond the fluid management of patients with shock. | Available online http ccforum.eom content 11 3 131 Commentary Pulse pressure variation beyond the fluid management of patients with shock Frédéric Michard1 Marcel R Lopes2 and Jose-Otavio C Auler Jr3 1 Department of Anesthesia and Critical Care Béclère Hospital - University Paris XI France 2Department of Anesthesia and Critical Care Santa Casa Misericordia de Passos Passos MG Brazil 3Department of Anesthesia and Critical Care INCOR - University of São Paulo São Paulo SP Brazil Corresponding author Frédéric Michard michard.frederic@free.fr Published 17 May 2007 This article is online at http ccforum.com content 11 3 131 2007 BioMed Central Ltd Critical Care 2007 11 131 doi 10.1186 cc5905 See related research by Keyl et al. http ccforum.com content 11 2 R46 Abstract In anesthetized patients without cardiac arrhythmia the arterial pulse pressure variation PPV induced by mechanical ventilation has been shown the most accurate predictor of fluid responsiveness. In this respect PPV has so far been used mainly in the decision-making process regarding volume expansion in patients with shock. As an indicator of the position on the Frank-Starling curve PPV may actually be useful in many other clinical situations. In patients with acute lung injury or with acute respiratory distress syndrome PPV can predict hemodynamic instability induced by positive end-expiratory pressure and recruitment maneuvers. PPV may also be useful to prevent excessive fluid restriction depletion in patients with pulmonary edema and to prevent excessive ultrafiltration in critically ill patients undergoing hemodialysis or hemofiltration. In the operating room a goal-directed fluid therapy based on PPV monitoring has the potential to improve the outcome of patients undergoing high-risk surgery. In the previous issue of Critical Care Keyl and colleagues 1 have investigated the effects of cardiac resynchronization therapy on arterial pulse pressure variation PPV . Many studies 2 have shown that PPV is .
