Influence of pressure control levels on the pulse pressure variations

An animal study using healthy piglets

Chih Hsin Lee, Yao Kuang Wu, Jann Yuan Wang, Chou Chin Lan, Chun Yi Lee, Kuei Yao Hsu, Kun Mao Chao, Hung Chang

Research output: Contribution to journalArticle

2 Citations (Scopus)

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 languageEnglish
Pages (from-to)628-632
Number of pages5
JournalShock
Volume36
Issue number6
DOIs
Publication statusPublished - Dec 2011
Externally publishedYes

Fingerprint

Blood Pressure
Pressure
Tidal Volume
Mechanical Ventilators
Hypovolemia
Hemorrhagic Shock
Critical Care
Artifacts
Arterial Pressure

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 journalArticle

Lee, Chih Hsin ; Wu, Yao Kuang ; Wang, Jann Yuan ; Lan, Chou Chin ; Lee, Chun Yi ; Hsu, Kuei Yao ; Chao, Kun Mao ; Chang, Hung. / Influence of pressure control levels on the pulse pressure variations : An animal study using healthy piglets. In: Shock. 2011 ; Vol. 36, No. 6. pp. 628-632.
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