Pulse pressure variation to predict fluid responsiveness in spontaneously breathing patients: tidal vs forced inspiratory breathing

• Published in: Anaesthesia 2014-07, Vol.69 (7), p.717-722
• Main Authors: Hong, D. M., Lee, J. M., Seo, J. H., Min, J. J., Jeon, Y., Bahk, J. H.
• Format: Article
• Language: English
• Subjects: Airway management; Anesthesia; Blood pressure; Blood Pressure - physiology; Cardiac Output - physiology; Female; Fluid Therapy; Hemodynamics - physiology; Humans; Hydroxyethyl Starch Derivatives - administration & dosage; Inspiratory Capacity - physiology; Male; Middle Aged; Plasma Substitutes - administration & dosage; Predictive Value of Tests; Reference Values; Respiration; Respiration, Artificial - methods; ROC Curve; Stroke Volume - physiology; Tidal Volume - physiology
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/anae.12678

Summary We evaluated whether pulse pressure variation can predict fluid responsiveness in spontaneously breathing patients. Fifty‐nine elective thoracic surgical patients were studied before induction of general anaesthesia. After volume expansion with hydroxyethyl starch 6 ml.kg−1, patients were defined as responders by a ≥ 15% increase in the cardiac index. Haemodynamic variables were measured before and after volume expansion and pulse pressure variations were calculated during tidal breathing and during forced inspiratory breathing. Median (IQR [range]) pulse pressure variation during forced inspiratory breathing was significantly higher in responders (n = 29) than in non‐responders (n = 30) before volume expansion (18.2 (IQR 14.7–18.2 [9.3–31.3])% vs 10.1 (IQR 8.3–12.6 [4.8–21.1])%, respectively, p