%0 Journal Article %1 AOR:AOR377 %A Westphal, Glauco %A Garrido, Alejandra del Pilar Gallardo %A De Almeida, Daniela Paoli %A Rocha e Silva, Maurício %A Poli-de Figueiredo, Luiz Francisco %D 2007 %I Blackwell Publishing Inc %J Artificial Organs %K cardiacoutput cdmrp hemorrhage vitals %N 4 %P 284--289 %R 10.1111/j.1525-1594.2007.00377.x %T Pulse Pressure Respiratory Variation as an Early Marker of Cardiac Output Fall in Experimental Hemorrhagic Shock %U http://dx.doi.org/10.1111/j.1525-1594.2007.00377.x %V 31 %X Abstract:  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 < 0.05). At ∼18% blood volume removal, significant changes in CO (2.4 ± 0.2 to 1.5 ± 0.2 mL/min, P <  0.05), ΔPp (12.6 ± 1.4 to 15.8 ± 2.0%, P < 0.05), and SvO2 (82 ± 1.4 to 73 ± 1.7%, P < 0.05) were observed. Alterations in MAP, RAP, PAOP, and ΔPs could be detected only after each animal had lost over 36% of estimated initial blood volume. There was correlation between blood volume loss and SV, CO, and SvO2, as well as between blood loss and MAP, ΔPp, and ΔPs. Blood volume loss showed no correlation with cardiac filling pressures. ΔPp is a useful, early marker of SV and CO for the assessment of cardiac preload changes in hemorrhagic shock, while cardiac filling pressures are not.

@article{AOR:AOR377, abstract = {Abstract:  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 < 0.05). At ∼18% blood volume removal, significant changes in CO (2.4 ± 0.2 to 1.5 ± 0.2 mL/min, P <  0.05), ΔPp (12.6 ± 1.4 to 15.8 ± 2.0%, P < 0.05), and SvO2 (82 ± 1.4 to 73 ± 1.7%, P < 0.05) were observed. Alterations in MAP, RAP, PAOP, and ΔPs could be detected only after each animal had lost over 36% of estimated initial blood volume. There was correlation between blood volume loss and SV, CO, and SvO2, as well as between blood loss and MAP, ΔPp, and ΔPs. Blood volume loss showed no correlation with cardiac filling pressures. ΔPp is a useful, early marker of SV and CO for the assessment of cardiac preload changes in hemorrhagic shock, while cardiac filling pressures are not.}, added-at = {2017-08-16T23:26:46.000+0200}, author = {Westphal, Glauco and Garrido, Alejandra del Pilar Gallardo and De Almeida, Daniela Paoli and Rocha e Silva, Maurício and Poli-de Figueiredo, Luiz Francisco}, biburl = {https://www.bibsonomy.org/bibtex/2982b32633e4e1a8553e9895821fa09fd/bryannowroozi}, doi = {10.1111/j.1525-1594.2007.00377.x}, interhash = {7431f3a8124287a8ef6e33a18a85dcaf}, intrahash = {982b32633e4e1a8553e9895821fa09fd}, issn = {1525-1594}, journal = {Artificial Organs}, keywords = {cardiacoutput cdmrp hemorrhage vitals}, number = 4, pages = {284--289}, publisher = {Blackwell Publishing Inc}, timestamp = {2017-08-16T23:26:46.000+0200}, title = {Pulse Pressure Respiratory Variation as an Early Marker of Cardiac Output Fall in Experimental Hemorrhagic Shock}, url = {http://dx.doi.org/10.1111/j.1525-1594.2007.00377.x}, volume = 31, year = 2007 }