tailieunhanh - Báo cáo y học: " Pulse pressure variation and stroke volume variation during increased intra-abdominal pressure: an experimental study"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Pulse pressure variation and stroke volume variation during increased intra-abdominal pressure: an experimental study. | Jacques et al. Critical Care 2011 15 R33 http content 15 1 R33 KS CRITICAL CARE RESEARCH Open Access Pulse pressure variation and stroke volume variation during increased intra-abdominal pressure an experimental study rjididr locv 11 loc l ri n Rdocliolicl2 Como ril loorrot3 oollo C lllior i3 1 100006 Dirioi I4 oxo-Pc I iolo5 Didier Jacques Ixani 11 Bel Idjelid Serge Duperret Joelle Colling Vincent piiiou Jean ram Viale Abstract Introduction The aim of this study was to evaluate dynamic indices of fluid responsiveness in a model of intraabdominal 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 Adown . 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 Adown 13 5 vs 6 4 mmHg were higher in responders than in non-responders P . Areas under ROC curves were 95 confidence interval to to to to and to respectively. Threshold values discriminating responders