• In Byung Kim, Nigel Fealy, Ian Baldwin, and Rinaldo Bellomo.
• Department of Emergency Medicine, Kwan Dong University, Seoul, Korea.
• Crit Care Resusc. 2011 Sep 1;13(3):156-61.

BackgroundA pulse pressure variation (PPV) ≥ 13% of mean arterial pressure (MAP) is an accepted marker of a fluid-responsive state. However, there is no study of its epidemiology and associations among non-cardiac critically ill patients.ObjectivesTo conduct a pilot study of the epidemiology and associations of a PPV ≥ 13% among non-cardiac critically ill patients.DesignProspective observational study.SettingIntensive care unit of a university hospital.PatientsCohort of 37 sedated critically ill patients undergoing mandatory ventilation.Main Outcome MeasuresPPV values, tidal volume and peak airway pressure, MAP, heart rate (HR) and central venous pressure (CVP) collected every 15 minutes; fluid balance collected hourly; correlation between PPV and these variables.Results450 PPV measurements were collated. The PPV value was ≥ 13% in 86 (19%) measurements and was observed in two consecutive measurements in 68 (15%) of cases. On multivariable analysis, mean PPV was significantly correlated with CVP (P=0.04), HR (P<0.001) and peak airway pressure (P=0.001), but not fluid balance (P=0.3).ConclusionsAmong non-cardiac surgery mechanically ventilated patients, a PPV in the fluid-responsive range was present in one-fifth of measurements and showed logical correlations with relevant haemodynamic and mechanical ventilation-related variables. Our results provide a rationale for a more comprehensive evaluation of PPV measurement in suitable critically ill patients.

14 keywords...

hide…