title: [Influence of open chest conditions on pulse pressure variations].
abstract: OBJECTIVE
  Pulse pressure variations are used to assess fluid responsiveness in mechanically ventilated patients. The accuracy of this index in open chest conditions remained unclear. The aim of the study was to evaluate the effect of open chest conditions on pulse pressure variations.
  
  
  METHODS
  Non-interventional prospective study.
  
  
  METHODS
  Twenty-eight mechanically ventilated patients scheduled for open-heart surgery were included. Pulse pressure variations, peak aortic velocity, and stroke volume were measured before and after thoracotomy with pericardotomy. Measurements were made at each step and compared.
  
  
  RESULTS
  Neither pulse pressure variation nor peak aortic velocity and nor stroke volume variation were modified by open chest conditions (median=5% [interquartile range=6] vs 4% [6], p=NS), (20% [11] vs 17% [12], p=NS and 11% [7] vs 10% [3], p=NS) respectively. Pulse pressure variations were correlated to stroke volume before thoracotomy (r'=-0.432; p=0.02) and after thorocatomy (r'=-0.433, p=0.02).
  
  
  CONCLUSIONS
  In these studied patients, preload dependancy indices were not modified by open chest conditions. Pulse pressure variations remained correlated to stroke volume even after thoracotomy.
authors.affiliation: Pôle anesthésie-réanimation, CHU d'Amiens, 1 place Victor-Pauchet, Amiens, France. lorne.emmanuel@chu-amiens.fr
authors.forename: E
authors.initials: E
authors.lastname: Lorne
authors.forename: Y
authors.initials: Y
authors.lastname: Mahjoub
authors.forename: E
authors.initials: E
authors.lastname: Zogheib
authors.forename: G
authors.initials: G
authors.lastname: Debec
authors.forename: A
authors.initials: A
authors.lastname: Ben Ammar
authors.forename: F
authors.initials: F
authors.lastname: Trojette
authors.forename: B
authors.initials: B
authors.lastname: Dehedin
authors.forename: J-P
authors.initials: JP
authors.lastname: Remadi
authors.forename: T
authors.initials: T
authors.lastname: Caus
authors.forename: H
authors.initials: H
authors.lastname: Dupont
mesh_terms: D000368:Aged; D000465:Algorithms; D001794:Blood Pressure / Q000502:physiology*; D006348:Cardiac Surgical Procedures; D056805:Consciousness Monitors; D005260:Female; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D011446:Prospective Studies; D011674:Pulse; D012121:Respiration, Artificial; D013318:Stroke Volume / Q000502:physiology; D013908:Thoracotomy