Using an expiratory resistor, arterial pulse pressure variations predict fluid responsiveness during spontaneous breathing an experimental porcine study 英文参考文献.docVIP

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Using an expiratory resistor, arterial pulse pressure variations predict fluid responsiveness during spontaneous breathing an experimental porcine study 英文参考文献.doc

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Using an expiratory resistor, arterial pulse pressure variations predict fluid responsiveness during spontaneous breathing an experimental porcine study 英文参考文献

Available online /content/13/2/R39 Research Open Access Vol 13 No 2 Using an expiratory resistor, arterial pulse pressure variations predict fluid responsiveness during spontaneous breathing: an experimental porcine study Michael K Dahl, Simon T Vistisen, Jacob Koefoed-Nielsen and Anders Larsson Anaesthesia and Intensive Care Medicine, North Denmark Region, Aalborg Hospital – Aarhus University Hospitals, Hobrovej 18-22, DK-9000 Aalborg, Denmark Corresponding author: Michael K Dahl, mida@rn.dk Received: 23 Oct 2008 Revisions requested: 14 Jan 2009 Revisions received: 11 Feb 2009 Accepted: 20 Mar 2009 Published: 20 Mar 2009 Critical Care 2009, 13:R39 (doi:10.1186/cc7760) This article is online at: /content/13/2/R39 ? 2009 Dahl et al.; licensee BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Abstract Introduction Fluid responsiveness prediction is difficult in spontaneously breathing patients. Because the swings in intrathoracic pressure are minor during spontaneous breathing, dynamic parameters like pulse pressure variation (PPV) and systolic pressure variation (SPV) are usually small. We hypothesized that during spontaneous breathing, inspiratory and/or expiratory resistors could induce high arterial pressure variations at hypovolemia and low variations at normovolemia and hypervolemia. Furthermore, we hypothesized that SPV and PPV could predict fluid responsiveness under these conditions. Results Stroke volume was significantly lower at hypovolemia compared with normovolemia, but no differences were found between normovolemia and 20% or 40% hypervolemia. Compared with breathing through no resistor, SPV was magnified by all resistors at hypovolemia whereas there