title: Systolic pressure variation and pulse pressure variation during modifications of arterial pressure.
abstract: 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.
authors.affiliation: Department of Anesthesiology, University of Hamburg, Hamburg-Eppendorf University Hospital, Hamburg, Germany. jkubitz@uke.uni-hamburg.de
authors.forename: Jens C
authors.initials: JC
authors.lastname: Kubitz
authors.forename: Stefanie
authors.initials: S
authors.lastname: Forkl
authors.forename: Thorsten
authors.initials: T
authors.lastname: Annecke
authors.forename: Nils
authors.initials: N
authors.lastname: Kronas
authors.forename: Alwin E
authors.initials: AE
authors.lastname: Goetz
authors.forename: Daniel A
authors.initials: DA
authors.lastname: Reuter
mesh_terms: 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*
chemical_list: D000316:Adrenergic alpha-Agonists; D014662:Vasoconstrictor Agents; D010656:Phenylephrine