scholarly journals Comparison of the Efficacy of Different Arterial Waveform-Derived Variables (Pulse Pressure Variation, Stroke Volume Variation, Systolic Pressure Variation) for Fluid Responsiveness in Hemodynamically Unstable Mechanically Ventilated Critically Ill Patients

2021 ◽  
Vol 25 (1) ◽  
pp. 48-53
Author(s):  
Nitish Kumar ◽  
Deepak Malviya ◽  
Soumya S Nath ◽  
Shivani Rastogi ◽  
Vishal Upadhyay
Keyword(s):  
Stroke Volume ◽  
Pulse Pressure ◽  
Critically Ill Patients ◽  
Pulse Pressure Variation ◽  
Stroke Volume Variation ◽  
Systolic Pressure ◽  
Pressure Variation ◽  
Arterial Waveform ◽  
Mechanically Ventilated ◽  
Systolic Pressure Variation

scholarly journals Correlation of systolic pressure variation, pulse pressure variation and stroke volume variation in different preload conditions following a single dose mannitol infusion in elective neurosurgical patients

2016 ◽  
Vol 03 (03) ◽  
pp. 219-226 ◽  
Author(s):  
Ganesamoorthi Arimanickam ◽  
Sethuraman Manikandan
Keyword(s):  
Stroke Volume ◽  
Pulse Pressure ◽  
Pulse Pressure Variation ◽  
Stroke Volume Variation ◽  
Systolic Pressure ◽  
Pressure Variation ◽  
Operating Characteristics ◽  
Systolic Pressure Variation ◽  
Volume Variation ◽  
Neurosurgical Patients

Abstract Background: A Prospective observational study was designed assess the correlation between arterial pressure waveform derived indices and echocardiography derived stroke volume variation (SVV) at different preload conditions in patients undergoing elective craniotomies. Methods: Systolic pressure variation (SPV) and pulse pressure variation (PPV) were calculated from the arterial waveform. SVV was measured from transoesophageal echocardiography. After measuring baseline values for all three parameters, 1 g/kg of mannitol infusion (20%) was given over 15–20 min. Repeated measurements of SPV, PPV, SVV, urine output and peak airway pressure were done at the interval of 15, 30, 60, 90 and 120 min after stopping mannitol infusion. Pearson correlation coefficient (level of significance), and receiver operating characteristics curve were used for statistical analysis. Results: Significant correlation was present between SPV and SVV throughout the study. Significant correlation between SPV and PPV was present only at 90 min and 2 h after mannitol. The predictive effect of SPV and PPV in differentiating a volume loss ≥10 mL/kg was better than SVV. The best cut-off values for SPV, PPV and SVV were 12%, 9% and 20%, respectively. Conclusions: During mechanical ventilation with a tidal volume of 8 mL/kg, SPV correlated significantly with SVV at different preload conditions following mannitol infusion. PPV correlated poorly with SVV. SPV and PPV correlated only in the presence of hypovolaemia.

scholarly journals Pulse pressure variation and systolic pressure variation in mechanically ventilated children

2011 ◽  
Vol 51 (1) ◽  
pp. 34
Author(s):  
Johnny Nurman ◽  
Antonius H. Pudjiadi ◽  
Arwin A. P. Akib
Keyword(s):  
Cardiac Index ◽  
Pulse Pressure ◽  
Pulse Pressure Variation ◽  
Systolic Pressure ◽  
Pressure Variation ◽  
Arterial Line ◽  
Mechanically Ventilated ◽  
Systolic Pressure Variation ◽  
Bivariate Correlation ◽  
Ventilated Patients

Background In mechanically ventilated patients, changes in breathing patterns may affect the preload, causing stroke volume fluctuation. Pulse pressure variation (PPV) and systolic pressure variation (SPV) are dynamic means of the hemodynamic monitoring in ventilated patients. No study on PPV and SPY in children has been reported to date.Objective To study changes in PPV and SPY values in mechanically ventilated children.Method A descriptive cross􀁏sectional study was done at the Pediatric Critical Care Unit (PICU), Cipto Mangunkusumo Hospital, Jakarta. Subjects were mechanically ventilated children aged > 12 months. Echocardiography was performed in all patients to determine the cardiac index. Arterial pressure was measured by connecting an arterial line to a vital signs monitor. PPV and SPV were calculated using the standard formulas. Bivariate correlation tests were performed between cardiac index and PPV and between cardiac index and SPV. Receiver operator characteristic (ROC) curve analysis was done to determine the optimum PPV and SPV cut-off points to predict normal cardiac index (2:3.5 L/minute/m2).Results Eighteen patients were enrolled in the study, yielding 48 measurements. Mean cardiac index was 2.9 (SD 1-2.6) L/minute/m2. Median PPV was 18.9 (range 4.1-45.5)% and SPV was 12.1 (range 3.8- 18.9)%. We found strong negative correlations between PPY and cardiac index (r= ; p = ) and SPY and cardiac index (r= ; p = ). To predict nonnal cardiac index, the optimum cut-off point was 11.4% for PPV (100% sensitivity, 100% specificity) and 9.45% for SPV (91.7% sensitivity, 100% specificity).Conclusion In mechanically ventilated children, cardiac index is negatively correlated with PPV and SPV.

scholarly journals Echocardiographic measure of dynamic arterial elastance predict pressure response during norepinephrine weaning: an observational study

2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Maxime Nguyen ◽  
Osama Abou-Arab ◽  
Stéphane Bar ◽  
Hervé Dupont ◽  
Bélaïd Bouhemad ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Pulse Pressure ◽  
Pulse Pressure Variation ◽  
Stroke Volume Variation ◽  
Pressure Variation ◽  
Pressure Response ◽  
Arterial Elastance ◽  
Volume Variation ◽  
Norepinephrine Dose ◽  
Stroke Volume Variations

AbstractThe purpose of this study was to determine whether dynamic elastance EAdyn derived from echocardiographic measurements of stroke volume variations can predict the success of a one-step decrease of norepinephrine dose. In this prospective single-center study, 39 patients with vasoplegic syndrome treated with norepinephrine and for whom the attending physician had decided to decrease norepinephrine dose and monitored by thermodilution were analyzed. EAdyn is the ratio of pulse pressure variation to stroke volume variation and was calculated from echocardiography stroke volume variations and from transpulmonary thermodilution. Pulse pressure variation was obtained from invasive arterial monitoring. Responders were defined by a decrease in mean arterial pressure (MAP) > 10% following norepinephrine decrease. The median decrease in norepinephrine was of 0.04 [0.03–0.05] µg kg−1 min−1. Twelve patients (31%) were classified as pressure responders with a median decrease in MAP of 13% [12–15%]. EAdyn was lower in pressure responders (0.40 [0.24–0.57] vs 0.95 [0.77–1.09], p < 0.01). EAdyn was able to discriminate between pressure responders and non-responders with an area under the curve of 0.86 (CI95% [0.71 to1.0], p < 0.05). The optimal cut-off was 0.8. EAdyn calculated from the echocardiographic estimation of the stroke volume variation and the invasive arterial pulse pressure variation can be used to discriminate pressure response to norepinephrine weaning. Agreement between EAdyn calculated from echocardiography and thermodilution was poor. Echocardiographic EAdyn might be used at bedside to optimize hemodynamic treatment.

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