Pulse Pressure Respiratory Variation as an Early Marker of Cardiac Output Fall in Experimental Hemorrhagic Shock

• Published in: Artificial organs 2007-04, Vol.31 (4), p.284-289
• Main Authors: Westphal, Glauco, Garrido, Alejandra del Pilar Gallardo, De Almeida, Daniela Paoli, Rocha e Silva, Maurício, Poli-de-Figueiredo, Luiz Francisco
• Format: Article
• Language: English
• Subjects: Animals; Arterial pressure; Biomarkers; Blood Pressure - physiology; Blood Transfusion; Blood Volume; Cardiac Output - physiology; Disease Models, Animal; Dogs; Dynamic monitoring; Fluid replacement; Hemorrhagic shock; Hypovolemia - physiopathology; Hypovolemia - therapy; Male; Respiration, Artificial; Shock; Shock, Hemorrhagic - physiopathology; Shock, Hemorrhagic - therapy; Stroke Volume - physiology
• ISSN: 0160-564X; 1525-1594
• DOI: 10.1111/j.1525-1594.2007.00377.x

:  Pulse pressure (ΔPp) and systolic pressure (ΔPs) variations have been recommended as predictors of fluid responsiveness in critically ill patients. We hypothesized that changes in ΔPp and ΔPs parallel alterations in stroke volume (SV) and cardiac output (CO) during hemorrhage, shock, and resuscitation. In anesthetized and mechanically ventilated mongrel dogs, a graded hemorrhage (20 mL/min) was induced to a target mean arterial pressure (MAP) of 40 mm Hg, which was maintained for additional 30 min. Total shed‐blood volume was then retransfused at a 40 mL/min rate. CO, SV, right atrial pressure (RAP), pulmonary artery occlusion pressure (PAOP), and continuous mixed venous oxygen saturation (SvO2) were assessed. Both ΔPp and ΔPs were calculated from direct arterial pressure waveform. Removal of about 9% of estimated blood volume promoted a reduction in SV (14.8 ± 2.2 to 10.6 ±  1.3 mL, P