Variable systolic pressure variation and dynamic hyperinflation due to an intrabronchial tumor.
Systolic pressure variation (SPV) is the cyclic change in systolic blood pressure secondary to positive-pressure ventilation. It is normally a good indicator of intravascular volume and often can be substituted for central venous pressure monitoring, but the reliability of SPV for this use depends on the multiple determinants of intrathoracic pressure remaining constant. We present a case in which an intrabronchial tumor caused dynamic hyperinflation of one lung. This situation, in turn, caused a marked increase in SPV but, more importantly, it increased variability of the SPV despite normal intravascular volume. We discuss the physiology of SPV and the implications of this case for the use of SPV as a monitor of intravascular volume.
Turner
Christopher R
CR
Department of Anesthesiology, University of Michigan Medical Center, Ann Arbor, MI 48109-0048, USA. turchris@med.umich.edu
Russell
Kelly Y
KY
Dorje
Pema
P
D000328:Adult; D001794:Blood Pressure; D001984:Bronchial Neoplasms / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D020896:Hypovolemia / Q000175:diagnosis; D007889:Leiomyoma / Q000150:complications / Q000175:diagnosis* / Q000601:surgery; D008168:Lung / Q000473:pathology; D008176:Lung Volume Measurements; D008577:Meningeal Neoplasms / Q000150:complications / Q000601:surgery; D008579:Meningioma / Q000150:complications / Q000601:surgery; D015656:Respiratory Mechanics; D013599:Systole