• F Espitalier, M Laffon, S Ehrmann, and E Masseret.
• Service de réanimation médicale, université F.-Rabelais, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France. Electronic address: antoine.guillon@univ-tours.fr.
• Ann Fr Anesth Reanim. 2013 Sep 1;32(9):548-53.

ObjectivePulse pressure variation (ΔPP) has been demonstrated to be an accurate dynamic parameter to predict fluid responsiveness. However, the impact of different ventilator modes on this parameter is unknown. We compared ΔPP values calculated alternatively during pressure- and volume-controlled ventilation.Study DesignDouble-blind randomized study, cross-over design.PatientsPatients in intensive care unit after a cardiac surgery.MethodPatients were ventilated alternatively in both ventilator modes (according to the randomization): volume-controlled ventilation (VVC) and pressure-controlled ventilation (VPC). Other parameters of ventilation were identical. ΔPP values were calculated for each patient in both ventilator modes.ResultsAmong the 26 patients analyzed, mean ΔPP value was de 14.0±7.3% in VVC and 11.8±6.2% in VPC (P<0,0001). On Bland-Altman representation, mean bias was +2.2±2.3% and inferior and superior limits of agreement were respectively -2.3 and 6.7%. Arterial blood pressure and central venous pressure were not modified.ConclusionΔPP values obtained with both ventilator modes were not interchangeable. On average, ΔPP decreases by more than two points in the passage VVC to VPC for a given patient, all others things being equal.Copyright © 2013 Société française d’anesthésie et de réanimation (Sfar). Published by Elsevier SAS. All rights reserved.

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