The clinical relevance of systolic pressure variations in anesthetized nonhypotensive patients.
OBJECTIVE
To assess the accuracy of respiratory-induced systolic pressure variation and its components to detect low left ventricular preload.


METHODS
Prospective study.


METHODS
University hospital.


METHODS
Sixty-seven patients undergoing major surgery under general anesthesia.


METHODS
Transesophageal echocardiographic measurements during apnea and mechanical ventilation.


RESULTS
Respiratory-induced systolic pressure variation and its components and left ventricular end-diastolic area obtained by transesophageal echocardiography were noted simultaneously. Arterial pressure indices did not allow a reliable diagnosis of a low left ventricular end-diastolic area using a cut-off value of 7.9 cm(2)/m(2) (inferior boundary of the interquartile range of the areas measured in the authors' group).


CONCLUSIONS
These results suggest that systolic pressure variations noticed after induction of general anesthesia do not reflect low left ventricular preload in nonhypotensive patients.
Dalibon
Nicolas
N
Service d'Anesthésie, Hôpital Foch, Suresnes, France.
Guenoun
Thierry
T
Journois
Didier
D
Frappier
Jerôme
J
Safran
Denis
D
Fischler
Marc
M
D000768:Anesthesia, General / Q000009:adverse effects*; D001794:Blood Pressure / Q000187:drug effects*; D017548:Echocardiography, Transesophageal; D006352:Heart Ventricles / Q000000981:diagnostic imaging / Q000503:physiopathology; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D020896:Hypovolemia / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D012372:ROC Curve; D012121:Respiration, Artificial; D012680:Sensitivity and Specificity; D013514:Surgical Procedures, Operative; D016277:Ventricular Function, Left / Q000502:physiology