Arterial Pressure Variation as a Biomarker of Preload Dependency in Spontaneously Breathing Subjects - A Proof of Principle

PloS One
Anne-Sophie G T BronzwaerJohannes J van Lieshout

Abstract

Pulse (PPV) and systolic pressure variation (SPV) quantify variations in arterial pressure related to heart-lung interactions and have been introduced as biomarkers of preload dependency to guide fluid treatment in mechanically ventilated patients. However, respiratory intra-thoracic pressure changes during spontaneous breathing are considered too small to affect preload and stroke volume sufficiently for the detection by PPV and/or SPV. This study addressed the effects of paced breathing and/or an external respiratory resistance on PPV and SPV in detecting preload dependency in spontaneously breathing subjects. In 10 healthy subjects, hemodynamic and respiratory parameters were evaluated during progressive central hypovolemia (head-up tilt). Breathing conditions were varied by manipulating breathing frequency and respiratory resistance. Subjects responding with a reduction in stroke volume index ≥15% were classified as having developed preload dependency. The ability for PPV and SPV to predict preload dependency was expressed by the area under the ROC curve (AUC). A breathing frequency at 6/min increased the PPV (16±5% vs. 10±3%, p<0.001) and SPV (9±3% vs. 5±2%, p<0.001) which was further enhanced by an expiratory resistance (...Continue Reading

References

Apr 1, 1967·Journal of Applied Physiology·C Lenfant
Aug 1, 1967·The American Journal of Physiology·A H MorenoJ H Burke
Apr 1, 1983·Pflügers Archiv : European journal of physiology·B NemeryA Frans
Oct 6, 1997·Acta Physiologica Scandinavica·A J VoogelJ M Karemaker
Jul 21, 2000·American Journal of Respiratory and Critical Care Medicine·F MichardJ L Teboul
Jun 18, 2002·Chest·Frédéric Michard, Jean-Louis Teboul
Jan 22, 2003·Intensive Care Medicine·Karim Bendjelid, Jacques-A Romand
Sep 5, 2003·Experimental Physiology·Mark P M HarmsNiels H Secher
May 1, 1963·The Journal of Physiology·I P PRIBAN
Mar 9, 2005·Intensive Care Medicine·Daniel De BackerJean-Louis Vincent
Sep 9, 2005·Acta Anaesthesiologica Scandinavica·J J van LieshoutN H Secher
Jul 19, 2006·Critical Care : the Official Journal of the Critical Care Forum·Sarah HeenenJean-Louis Vincent
Sep 1, 2007·Current Opinion in Critical Care·Michael R Pinsky
Sep 1, 2007·Current Opinion in Critical Care·Xavier Monnet, Jean-Louis Teboul
Mar 24, 2009·Critical Care : the Official Journal of the Critical Care Forum·Michael K DahlAnders Larsson
Apr 7, 2009·Intensive Care Medicine·Fabrice ValléeOlivier Fourcade
Apr 9, 2009·Anesthesiology·Daniel De BackerJean-Louis Vincent
Apr 29, 2009·British Journal of Anaesthesia·M Bundgaard-NielsenH Kehlet
Dec 19, 2009·Clinical Journal of the American Society of Nephrology : CJASN·Simona StancuGabriel Mircescu
Apr 16, 2011·Journal of Cardiothoracic and Vascular Anesthesia·Solomon Aronson, Joseph Varon
Apr 26, 2011·Journal of Critical Care·Hoi Ping ShumWing Wa Yan
May 3, 2011·Nature Methods·Julie Brind'Amour, Peter M Lansdorp
Jun 3, 2011·Epidemiologic Reviews·Iris Lansdorp-VogelaarHermann Brenner
Jul 7, 2011·Acta Anaesthesiologica Taiwanica : Official Journal of the Taiwan Society of Anesthesiologists·Christoph K Hofer, Maxime Cannesson
Dec 17, 2011·British Journal of Anaesthesia·Ø JansH Kehlet
Dec 22, 2011·British Journal of Anaesthesia·B LansdorpP Pickkers
May 6, 2014·Frontiers in Physiology·Anne-Sophie G T BronzwaerJohannes J van Lieshout

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Citations

Jul 6, 2016·Frontiers in Physiology·Anne-Sophie G T BronzwaerJohannes J van Lieshout
Jun 15, 2017·Current Opinion in Critical Care·Azriel Perel
May 26, 2017·Current Opinion in Critical Care·Simon T Vistisen, Peter Juhl-Olsen
Mar 16, 2017·Therapeutic Apheresis and Dialysis : Official Peer-reviewed Journal of the International Society for Apheresis, the Japanese Society for Apheresis, the Japanese Society for Dialysis Therapy·Fumiki YoshiharaSatoko Nakamura
Jun 26, 2017·Journal of Clinical Monitoring and Computing·Takashi JuriKiyonobu Nishikawa
Jan 23, 2018·Frontiers in Physiology·Björn J P van der SterJohannes J van Lieshout
Jul 4, 2017·Physiological Measurement·Frank C BennisTammo Delhaas
Dec 31, 2019·Acta Anaesthesiologica Scandinavica·Akira MukaiKiyonobu Nishikawa
Apr 25, 2018·Frontiers in Physiology·Björn J P van Der SterJohannes J van Lieshout

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