title: Pulse pressure variation and stroke volume variation under different inhaled concentrations of isoflurane, sevoflurane and desflurane in pigs undergoing hemorrhage.
abstract: OBJECTIVE
  Inhalant anesthesia induces dose-dependent cardiovascular depression, but whether fluid responsiveness is differentially influenced by the inhalant agent and plasma volemia remains unknown. The aim of this study was to compare the effects of isoflurane, sevoflurane and desflurane on pulse pressure variation and stroke volume variation in pigs undergoing hemorrhage.
  
  
  METHODS
  Twenty-five pigs were randomly anesthetized with isoflurane, sevoflurane or desflurane. Hemodynamic and echocardiographic data were registered sequentially at minimum alveolar concentrations of 1.00 (M1), 1.25 (M2), and 1.00 (M3). Then, following withdrawal of 30% of the estimated blood volume, these data were registered at a minimum alveolar concentrations of 1.00 (M4) and 1.25 (M5).
  
  
  RESULTS
  The minimum alveolar concentration increase from 1.00 to 1.25 (M2) decreased the cardiac index and increased the central venous pressure, but only modest changes in mean arterial pressure, pulse pressure variation and stroke volume variation were observed in all groups from M1 to M2. A significant decrease in mean arterial pressure was only observed with desflurane. Following blood loss (M4), pulse pressure variation, stroke volume variation and central venous pressure increased (p < 0.001) and mean arterial pressure decreased in all groups. Under hypovolemia, the cardiac index decreased with the increase of anesthesia depth in a similar manner in all groups.
  
  
  CONCLUSIONS
  The effects of desflurane, sevoflurane and isoflurane on pulse pressure variation and stroke volume variation were not different during normovolemia or hypovolemia.
authors.affiliation: Programa de Pós-Graduação em Anestesiologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Alexandre Hideaki
authors.initials: AH
authors.lastname: Oshiro
authors.affiliation: Programa de Pós-Graduação em Anestesiologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Denise Aya
authors.initials: DA
authors.lastname: Otsuki
authors.affiliation: Laboratório de Investigação Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Marcelo Waldir M
authors.initials: MW
authors.lastname: Hamaji
authors.affiliation: Laboratório de Investigação Médica, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Kaleizu T
authors.initials: KT
authors.lastname: Rosa
authors.affiliation: Programa de Pós-Graduação em Anestesiologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Keila Kazue
authors.initials: KK
authors.lastname: Ida
authors.affiliation: Departamento de Cirurgia, Faculdade de Medicina Veterinária e Zootecnia, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: Denise T
authors.initials: DT
authors.lastname: Fantoni
authors.affiliation: Programa de Pós-Graduação em Anestesiologia, Faculdade de Medicina, Universidade de São Paulo, São Paulo, SP, Brazil.
authors.forename: José Otavio Costa
authors.initials: JO
authors.lastname: Auler
mesh_terms: D018685:Anesthetics, Inhalation / Q000494:pharmacology*; D000818:Animals; D001794:Blood Pressure / Q000187:drug effects*; D000077335:Desflurane; D004305:Dose-Response Relationship, Drug; D005260:Female; D006470:Hemorrhage / Q000503:physiopathology; D020896:Hypovolemia / Q000503:physiopathology*; D007530:Isoflurane / Q000031:analogs & derivatives / Q000494:pharmacology; D008297:Male; D008738:Methyl Ethers / Q000494:pharmacology; D011897:Random Allocation; D012016:Reference Values; D000077149:Sevoflurane; D013318:Stroke Volume / Q000187:drug effects*; D013552:Swine; D013997:Time Factors
chemical_list: D018685:Anesthetics, Inhalation; D008738:Methyl Ethers; D000077149:Sevoflurane; D000077335:Desflurane; D007530:Isoflurane