Conclusion
Variation in pulse pressure is probably a good parameter for management of fluid requirement in patients with circulatory failure. Its measurement is less invasive than that of other parameters, and several studies have reported its value in clinical practice. However, reliable use of this parameter is dependent on awareness that there are pitfalls with a strong underlying physiological rationale, especially in an unselected population.
Access this chapter
Tax calculation will be finalised at checkout
Purchases are for personal use only
Preview
Unable to display preview. Download preview PDF.
References
Massumi R, Mason D, Zauddin V, Zelis R, Otero J, Amsterdam E (1976) Reversed pulsus paradoxus. N Engl J Med 289:1272–1275
Guyton A, Linsdsey A, Abernathy B, Richardson T (1957) Venous return at various right atrial pressures and the normal venous return curve. Am J Physiol 189:609–615
Jardin F, Delorme G, Hardy A, Auvert B, Beauchet A, Bourdarias JP (1990) Reevaluation of hemodynamic consequences of positive pressure ventilation: emphasis on cyclic right ventricular afterloading by mechanical lung inflation. Anesthesiology 72:966–970
Coyle JP, Teplick RS, Long MC, Davison JK (1983) Respiratory variations in systemic arterial pressure as an indicator of volume status. Anesthesiology 59:A53 (abst)
Perel A, Pizov R, Cotev S (1987) Systolic blood pressure variation is a sensitive indicator of hypovolemia in ventilated dogs subjected to graded hemorrhage. Anesthesiology 67:498–502
Tavernier B, Makhotine O, Lebuffe G, Dupont J, Scherpereel P (1998) Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology 89:1313–1321
Denault A, Gasior T, Gorcsan J, Mandarino W, Deneault L, Pinsky M (1999) Determinants of aortic pressure variation during positive-pressure ventilation in man. Chest 116:178–186
Michard F, Boussat S, Chemla D, et al (2000) Relation between respiratory changes in arterial pulse pressure and fluid responsiveness in septic patients with acute circulatory failure. Am J Respir Crit Care Med 162:134–138
Jardin F, Farcot JC, Gueret P, Prost JF, Ozier Y, Bourdarias JP (1983) Cyclic changes in arterial pulse during respiratory support. Circulation 68:266–274
Vieillard-Baron A, Chergui K, Rabiller A, et al (2004) Superior vena caval collapsibility as a gauge of volume status in ventilated septic patients. Intensive Care Med 30:1734–1739
Versprille A (1990) The pulmonary circulation during mechanical ventilation. Acta Anaesthesiol Scand 34(Suppl 94):51–62
Vieillard-Baron A, Chergui K, Augarde R, et al (2003) Cyclic changes in arterial pulse during respiratory support revisited by Doppler echocardiography. Am J Respir Crit Care Med 168:671–676
Vieillard-Baron A, Loubières Y, Schmitt JM, Page B, Dubourg O, Jardin F (1999) Cyclic changes in right ventricular outflow impedance during mechanical ventilation. J Appl Physiol 87:1644–1650
Vieillard-Baron A, Schmitt JM, Augarde R, et al (2001) Acute cor pulmonale in acute respiratory distress syndrome submitted to protective ventilation: incidence, clinical implications, and prognosis. Crit Care Med 29:1551–1555
Vieillard-Baron A, Prin S, Chergui K, Dubourg O, Jardin F (2002) Echo-Doppler demonstration of acute cor pulmonale at the bedside in the medical intensive care unit. Am J Respir Crit Care Med 166:1310–1319
Magder S (2004) Clinical usefulness of respiratory variations in arterial pulse. Am J Respir Crit Care Med 169:151–155
De Backer D, Heenen S, Piagnerelli M, Koch M, Vincent JL (2005) Pulse pressure variations to predict fluid responsiveness: influence of tidal volume. Intensive Care Med 31:517–523
Teboul JL, Vieillard-Baron A (2005) Clinical value of pulse pressure variations in ARDS. Still an unresolved issue? Intensive Care Med 31:499–500
Reuter D, Felbinger T, Schmidt C, et al (2002) Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery. Intensive Care Med 28:392–398
Gattinoni L, Pelosi P, Suter P, Pedoto A, Vercesi P, Lissoni A (1998) Acute respiratory distress syndrome caused by pulmonary and extra-pulmonary disease. Different syndromes? Am J Respir Crit Care Med 156:3–11
The Acute Respiratory Distress Syndrome Network (2000) Ventilation with lower tidal volumes as compared with traditional tidal volumes for acute lung injury and the acute respiratory distress syndrome. N Engl J Med 342:1301–1308
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2006 Springer-Verlag Berlin Heidelberg
About this paper
Cite this paper
Vieillard-Baron, A. (2006). Pulse Pressure Variations in Managing Fluid Requirement: Beware the Pitfalls!. In: Vincent, JL. (eds) Yearbook of Intensive Care and Emergency Medicine. Yearbook of Intensive Care and Emergency Medicine, vol 2006. Springer, Berlin, Heidelberg. https://doi.org/10.1007/3-540-33396-7_18
Download citation
DOI: https://doi.org/10.1007/3-540-33396-7_18
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-30155-4
Online ISBN: 978-3-540-33396-8
eBook Packages: MedicineMedicine (R0)