Pulse Pressure Variation Helps to Predict Fluid Responsiveness in Patients Ventilated With Low Tidal Volumes
Objective: To determine the value of pulse pressure variation (ΔRESPPP) to predict fluid responsiveness in patients ventilated with low tidal volumes (VT), and to investigate whether a lower ΔRESPPP cut-off point should be used when patients are ventilated with low tidal volumes.
Methods: This cross-sectional, observational study included 37 critically ill patients with acute circulatory failure requiring fluid challenge. They were sedated and mechanically ventilated with Tidal Volume (VT) 6-7 ml/kg IBW (ideal body weight), monitored by pulmonary artery catheter and arterial line. Mechanical ventilation and hemodynamic parameters, including ΔRESPPP, were measured before and after fluid challenge with 1,000 ml crystalloids or 500 ml colloids. Fluid responsiveness was defined as an increase of at least 15% in cardiac index.
The present study was designed to (1) determine the value of ΔRESPPP to predict fluid responsiveness in patients ventilated with low tidal volumes, and (2) to investigate whether a lower ΔRESPPP cut-off point should be used when patients are ventilated with low tidal volumes.
The study hypothesis is not a good predictor of fluid responsiveness in patients ventilated with low tidal volumes.
|Study Design:||Observational Model: Cohort
Time Perspective: Cross-Sectional
|Official Title:||Pulse Pressure Variation Helps to Predict Fluid Responsiveness in Patients Ventilated With Low Tidal Volumes|
- Increase in cardiac index at least 15% of baseline value. [ Time Frame: Cardiac index was measured at the end of a 30 minutes fluid challenge. ] [ Designated as safety issue: No ]Patients were sedated and ventilated in controlled pressure or controlled volume mode (Servo I system v.12 or Servo 900 C, Siemens, Sweden) with VT < 8 ml/kg ideal body weight. Ventilatory and hemodynamic variables were measured before and after FC with the patients in a supine position. Fluid challenge was performed with 1000 ml 0.9% saline solution or lactated Ringer's solution or 500 ml hydroxy-ethyl-starch solution 6% 130/0.4 for 30 minutes. The increase in cardiac index was measured immediately after fluid challenge.
- Mortality [ Time Frame: 28 days ] [ Designated as safety issue: No ]Patients were followed for 28 days or until ICU discharge
|Study Start Date:||May 2006|
|Study Completion Date:||October 2009|
|Primary Completion Date:||October 2009 (Final data collection date for primary outcome measure)|
|Hospital de Clinicas de Porto Alegre|
|Porto Alegre, Rio Grande do Sul, Brazil, 90035903|
|Principal Investigator:||Gilberto Friedman||Hospital de Clinicas de Porto Alegre|