pulse pressure variation and stroke volume variation during increased intra-abdominal pressure an experimental study脉压变化和中风体积变化在腹腔压力增加的实验研究.pdfVIP

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pulse pressure variation and stroke volume variation during increased intra-abdominal pressure an experimental study脉压变化和中风体积变化在腹腔压力增加的实验研究.pdf

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pulse pressure variation and stroke volume variation during increased intra-abdominal pressure an experimental study脉压变化和中风体积变化在腹腔压力增加的实验研究

Jacques et al. Critical Care 2011, 15:R33 /content/15/1/R33 RESEARCH Open Access Pulse pressure variation and stroke volume variation during increased intra-abdominal pressure: an experimental study 1* 2 3 3 4 5 Didier Jacques , Karim Bendjelid , Serge Duperret , Joëlle Colling , Vincent Piriou , Jean-Paul Viale Abstract Introduction: The aim of this study was to evaluate dynamic indices of fluid responsiveness in a model of intra- abdominal hypertension. Methods: Nine mechanically-ventilated pigs underwent increased intra-abdominal pressure (IAP) by abdominal banding up to 30 mmHg and then fluid loading (FL) at this IAP. The same protocol was carried out in the same animals made hypovolemic by blood withdrawal. In both volemic conditions, dynamic indices of preload dependence were measured at baseline IAP, at 30 mmHg of IAP, and after FL. Dynamic indices involved respiratory variations in stroke volume (SVV), pulse pressure (PPV), and systolic pressure (SPV, %SPV and Δdown). Stroke volume (SV) was measured using an ultrasound transit-time flow probe placed around the aortic root. Pigs were considered to be fluid responders if their SV increased by 15% or more with FL. Indices of fluid responsiveness were compared with a Mann-Whitney U test. Then, receiver operating characteristic (ROC) curves were generated for these parameters, allowing determination of the cut-off values by using Youden’s method. Results: Five animals before blood withdrawal and all animals after blood withdrawal were fluid responders. Before FL, SVV (78 ± 19 vs 42 ± 17%), PPV (64 ± 18 vs 37 ± 15%), SPV (24 ± 5 vs 18 ± 3 mmHg), %SPV (24 ± 4 vs 17 ± 3%) and Δdown (13 ± 5 vs 6 ± 4 mmHg) were higher in responders than in non-r