• E Lorne, Y Mahjoub, E Zogheib, G Debec, A Ben Ammar, F Trojette, B Dehedin, J-P Remadi, T Caus, and H Dupont.
• Pôle anesthésie-réanimation, CHU d'Amiens, 1 place Victor-Pauchet, Amiens, France. lorne.emmanuel@chu-amiens.fr
• Ann Fr Anesth Reanim. 2011 Feb 1;30(2):117-21.

ObjectivesPulse pressure variations are used to assess fluid responsiveness in mechanically ventilated patients. The accuracy of this index in open chest conditions remained unclear. The aim of the study was to evaluate the effect of open chest conditions on pulse pressure variations.Study DesignNon-interventional prospective study.Methods And PatientsTwenty-eight mechanically ventilated patients scheduled for open-heart surgery were included. Pulse pressure variations, peak aortic velocity, and stroke volume were measured before and after thoracotomy with pericardotomy. Measurements were made at each step and compared.ResultsNeither pulse pressure variation nor peak aortic velocity and nor stroke volume variation were modified by open chest conditions (median=5% [interquartile range=6] vs 4% [6], p=NS), (20% [11] vs 17% [12], p=NS and 11% [7] vs 10% [3], p=NS) respectively. Pulse pressure variations were correlated to stroke volume before thoracotomy (r'=-0.432; p=0.02) and after thorocatomy (r'=-0.433, p=0.02).ConclusionIn these studied patients, preload dependancy indices were not modified by open chest conditions. Pulse pressure variations remained correlated to stroke volume even after thoracotomy.Copyright © 2011 Elsevier Masson SAS. All rights reserved.

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