Pulse pressure and stroke volume variations during severe haemorrhage in ventilated dogs

H. Berkenstadt, Z. Friedman, S. Preisman, I. Keidan, D. Livingstone, A. Perel

Research output: Contribution to journalArticlepeer-review

Abstract

Background. Similarly to systolic pressure variation (SPV), pulse pressure variation (PPV) and stroke volume variation (SVV) derived from arterial pulse contour analysis have been shown to reflect fluid responsiveness in ventilated patients. However, unlike the SPV, both PPV and SVV have not been validated during extreme hypovolaemia. The aim of the present study was to examine whether these newly introduced variables respond to gradual hypovolaemia like the SPV by increasing gradually with each step of the haemorrhage even during extreme hypovolaemia. Methods. SPV, SVV and PPV were measured in 8 dogs following initial volume loading (10% of the estimated blood volume administered as colloid solution), 5 steps of graded haemorrhage, each consisting of 10% of the estimated blood volume, followed by retransfusion of the shed blood. [Results. The correlations of the SVV, SPV and PPV to the stroke volume (SV) throughout the study were -0.89, -0.91 and -0.91, respectively. Correlations of the CVP and the global enddiastolic volume (GEDV) of the heart chambers to the SV were 0.79 and 0.95, respectively. The SPV correlated significantly with both the PPV and the SVV (r=0.97 and 0.93 respectively). However, the PPV increased by more than 400% at 50% haemorrhage compared with increases of 200% and 120% for the SVV and %SPV, respectively. Conclusion. This study demonstrates that the present algorithm used for the calculation of the SVV and the formula used to calculate the PPV, perform well over a wide range of preload states including severe hypovolaemia. However, the PPV changes more than the SPV and SVV. This may be due to the changing relation of the SV to the pulse pressure when the filling of the aorta is greatly decreased.

Original languageEnglish
Pages (from-to)721-726
Number of pages6
JournalBritish Journal of Anaesthesia
Volume94
Issue number6
DOIs
StatePublished - Jun 2005

Keywords

  • Fluid, responsiveness
  • Heart, preload
  • Heart, stroke volume variation
  • Heart, systolic pressure variation
  • Monitoring, haemodynamic
  • Pulse, pressure variation

Fingerprint

Dive into the research topics of 'Pulse pressure and stroke volume variations during severe haemorrhage in ventilated dogs'. Together they form a unique fingerprint.

Cite this