Abstract
Pulse pressure variation (PPV) is a promising predictor for volume responsiveness. However, recent studies have criticized its validity during small tidal volume (TV) ventilation. The present study evaluated the influence of pressure control level (PCL) on PPV. Six anesthetized healthy piglets simulating hemorrhagic shock underwent five stages of intravascular volume status change. Each stage comprised four cycles of PCL manipulation. In each cycle, five different PCLs were applied in random order. Among 600 arterial pressure tracings obtained during PCL manipulations, 26 tracings were excluded because of signal artifact or ectopic beats. For the remaining 574 tracings, the percentage of normal beats among total recorded beats in each tracing was 99.80% ± 0.85%. When manipulating PCL causing an abrupt change within-16 ∼ +8 cmH 2O, the PPV responded rapidly and stabilized within 60 s after manipulation. With higher increment in PCL (+12 ∼ +16 cmH 2O), it required 90 s for PPV to stabilize. Under each cycle of PCL manipulation, the PPVs are linearly correlated to the PCL (r = 0.84 ± 0.21) and TV (r = 0.83 ± 0.22). The PPV as well as the slopes of the trend lines decreased from hypovolemic stages toward hypervolemic stages. Pulse pressure variation responds rapidly to change in ventilator setting and is linearly correlated with the PCL and TV. These characteristics may have important applications in critical care to improve the interpretation of PPV in accord to different ventilator settings.
| Original language | English |
|---|---|
| Pages (from-to) | 628-632 |
| Number of pages | 5 |
| Journal | Shock |
| Volume | 36 |
| Issue number | 6 |
| DOIs | |
| Publication status | Published - Dec 2011 |
| Externally published | Yes |
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Keywords
- heart-lung interaction
- mechanical ventilation
- monitoring
- shock
- Volume responsiveness
ASJC Scopus subject areas
- Critical Care and Intensive Care Medicine
- Emergency Medicine
Cite this
Influence of pressure control levels on the pulse pressure variations : An animal study using healthy piglets. / Lee, Chih Hsin; Wu, Yao Kuang; Wang, Jann Yuan; Lan, Chou Chin; Lee, Chun Yi; Hsu, Kuei Yao; Chao, Kun Mao; Chang, Hung.
In: Shock, Vol. 36, No. 6, 12.2011, p. 628-632.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Influence of pressure control levels on the pulse pressure variations
T2 - An animal study using healthy piglets
AU - Lee, Chih Hsin
AU - Wu, Yao Kuang
AU - Wang, Jann Yuan
AU - Lan, Chou Chin
AU - Lee, Chun Yi
AU - Hsu, Kuei Yao
AU - Chao, Kun Mao
AU - Chang, Hung
PY - 2011/12
Y1 - 2011/12
N2 - Pulse pressure variation (PPV) is a promising predictor for volume responsiveness. However, recent studies have criticized its validity during small tidal volume (TV) ventilation. The present study evaluated the influence of pressure control level (PCL) on PPV. Six anesthetized healthy piglets simulating hemorrhagic shock underwent five stages of intravascular volume status change. Each stage comprised four cycles of PCL manipulation. In each cycle, five different PCLs were applied in random order. Among 600 arterial pressure tracings obtained during PCL manipulations, 26 tracings were excluded because of signal artifact or ectopic beats. For the remaining 574 tracings, the percentage of normal beats among total recorded beats in each tracing was 99.80% ± 0.85%. When manipulating PCL causing an abrupt change within-16 ∼ +8 cmH 2O, the PPV responded rapidly and stabilized within 60 s after manipulation. With higher increment in PCL (+12 ∼ +16 cmH 2O), it required 90 s for PPV to stabilize. Under each cycle of PCL manipulation, the PPVs are linearly correlated to the PCL (r = 0.84 ± 0.21) and TV (r = 0.83 ± 0.22). The PPV as well as the slopes of the trend lines decreased from hypovolemic stages toward hypervolemic stages. Pulse pressure variation responds rapidly to change in ventilator setting and is linearly correlated with the PCL and TV. These characteristics may have important applications in critical care to improve the interpretation of PPV in accord to different ventilator settings.
AB - Pulse pressure variation (PPV) is a promising predictor for volume responsiveness. However, recent studies have criticized its validity during small tidal volume (TV) ventilation. The present study evaluated the influence of pressure control level (PCL) on PPV. Six anesthetized healthy piglets simulating hemorrhagic shock underwent five stages of intravascular volume status change. Each stage comprised four cycles of PCL manipulation. In each cycle, five different PCLs were applied in random order. Among 600 arterial pressure tracings obtained during PCL manipulations, 26 tracings were excluded because of signal artifact or ectopic beats. For the remaining 574 tracings, the percentage of normal beats among total recorded beats in each tracing was 99.80% ± 0.85%. When manipulating PCL causing an abrupt change within-16 ∼ +8 cmH 2O, the PPV responded rapidly and stabilized within 60 s after manipulation. With higher increment in PCL (+12 ∼ +16 cmH 2O), it required 90 s for PPV to stabilize. Under each cycle of PCL manipulation, the PPVs are linearly correlated to the PCL (r = 0.84 ± 0.21) and TV (r = 0.83 ± 0.22). The PPV as well as the slopes of the trend lines decreased from hypovolemic stages toward hypervolemic stages. Pulse pressure variation responds rapidly to change in ventilator setting and is linearly correlated with the PCL and TV. These characteristics may have important applications in critical care to improve the interpretation of PPV in accord to different ventilator settings.
KW - heart-lung interaction
KW - mechanical ventilation
KW - monitoring
KW - shock
KW - Volume responsiveness
UR - http://www.scopus.com/inward/record.url?scp=81755180528&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=81755180528&partnerID=8YFLogxK
U2 - 10.1097/SHK.0b013e3182353395
DO - 10.1097/SHK.0b013e3182353395
M3 - Article
VL - 36
SP - 628
EP - 632
JO - Shock
JF - Shock
SN - 1073-2322
IS - 6
ER -