Systolic pressure variation and pulse pressure variation during modifications of arterial pressure.
OBJECTIVE
This study was performed to investigate the effect of vasopressor therapy on systolic pressure variation (SPV) and pulse pressure variation (PPV) compared to experimentally measured left ventricular stroke volume variation (SVV).


METHODS
Prospective study in a university laboratory.


METHODS
Twelve anesthetized and mechanically ventilated pigs.


METHODS
Increase in mean arterial pressure (by 100%) using phenylephrine and decrease (by 38%) using adenosine.


RESULTS
SPV and PPV were calculated and compared to SVV derived from aortic blood flow measurements. SPV was significantly affected by changes in arterial pressure [4.6% (1.5) vs. 6.3% (2.1), p < 0.05, increased vs. decreased arterial pressure], whereas PPV did not change during modifications of arterial pressure. During baseline conditions and decreased afterload, correlation with SVV was good both for SPV (r =0.892 and r = 0.859, respectively) and for PPV (r = 0.870 and r = 0.871, respectively) (all p < 0.001). Correlation with SVV was only moderate during increased arterial pressure (r = 0.683 for SPV and r = 0.732 for PPV, p < 0.05).


CONCLUSIONS
For guiding fluid therapy in patients under vasopressor support, PPV seems superior to SPV.
Kubitz
Jens C
JC
Department of Anesthesiology, University of Hamburg, Hamburg-Eppendorf University Hospital, Hamburg, Germany. jkubitz@uke.uni-hamburg.de
Forkl
Stefanie
S
Annecke
Thorsten
T
Kronas
Nils
N
Goetz
Alwin E
AE
Reuter
Daniel A
DA
D000316:Adrenergic alpha-Agonists / Q000494:pharmacology*; D000704:Analysis of Variance; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects*; D010656:Phenylephrine / Q000494:pharmacology*; D011674:Pulse; D013318:Stroke Volume / Q000187:drug effects; D013552:Swine; D014662:Vasoconstrictor Agents / Q000494:pharmacology*
D000316:Adrenergic alpha-Agonists; D014662:Vasoconstrictor Agents; D010656:Phenylephrine