Relations between respiratory changes in R-wave amplitude and arterial pulse pressure in mechanically ventilated patients.
BACKGROUND
R-wave obtained from the electrocardiogram depends on ventricular stroke volume. We assessed the relationship between respiratory variations in R-wave (DeltaRDII) and in pulse pressure (DeltaPP) during general anesthesia.


METHODS
R-wave amplitude was measured from standard lead II (RDII). Maximal RDII (RDIImax) and minimal RDII (RDIImin) were determined over one respiratory cycle. DeltaRDII was calculated as 100 x [RDIImax-RDIImin]/([RDIImax + RDIImin]/2. DeltaRDII and DeltaPP were simultaneously recorded.


RESULTS
There was a significant relationship (r = 0.79; P < 0.001) between DeltaRDII and DeltaPP. A DeltaRDII > 13% detected patients with a DeltaPP > 13% with an 89% sensitivity, and an 88% specificity.


CONCLUSIONS
DeltaRDII and DeltaPP are related in this setting.
Cannesson
Maxime
M
Department of Anesthesiology & Perioperative Care, University of California, Irvine, Orange, 92868-3301, USA. maxime_cannesson@hotmail.com
Keller
Geoffray
G
Desebbe
Olivier
O
Lehot
Jean-Jacques
JJ
D000328:Adult; D000368:Aged; D000768:Anesthesia, General; D001794:Blood Pressure / Q000502:physiology*; D002245:Carbon Dioxide / Q000032:analysis; D004562:Electrocardiography; D045853:Exhalation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D008991:Monitoring, Physiologic; D012119:Respiration; D012121:Respiration, Artificial; D013318:Stroke Volume
D002245:Carbon Dioxide
J Clin Monit Comput. 2011 Feb;25(1):45-56
20390324
Anesthesiology. 2007 Jun;106(6):1105-11
17525584
Am Heart J. 1984 Apr;107(4):711-7
6702564
Crit Care Med. 2009 Sep;37(9):2642-7
19602972
J Clin Monit Comput. 2010 Apr;24(2):133-9
20130968
Circ Res. 1956 Nov;4(6):731-8
13365085
Anesth Analg. 2008 Apr;106(4):1195-200, table of contents
18349192
Chest. 1995 Oct;108(4):1041-8
7555117
IEEE Trans Biomed Eng. 2004 Dec;51(12):2198-203
15605869
Anesth Analg. 2008 Apr;106(4):1189-94, table of contents
18349191
Am J Respir Crit Care Med. 2000 Jul;162(1):134-8
10903232
Circulation. 1985 Sep;72(3):495-501
4017204
Anesthesiology. 2005 Aug;103(2):419-28; quiz 449-5
16052125
Lancet. 1986 Feb 8;1(8476):307-10
2868172
J Electrocardiol. 2003 Jul;36(3):263-71
12942491
Am J Cardiol. 1995 Oct 1;76(10):667-74
7572622
Am J Physiol. 1983 Oct;245(4):H580-3
6624926