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Evaluation of systolic pressure variation and pulse pressure variation in an experimental model of acute normovolemic hemodilution


Dynamic indicators derived from the arterial pressure waveform analysis as systolic pressure variation (SPV) and pulse pressure variation (PPV) have been shown to be a useful tool to optimize tissue perfusion in clinical and experimental studies. These indicators, however, have not been adequately explored in situations of acute variation of blood viscosity as occurs during acute normovolemic hemodilution (ANH). The purpose of this research was to compare the behavior of these dynamic indicators in a porcine model of ANH with two different solutions.


Fourteen pigs were anesthetized and randomly allocated into two groups: GI (ANH with 6% hydroxyethyl starch, 1:1) and GII (ANH with 0.9% saline solution, 1:3). Static and dynamic hemodynamic parameters were evaluated at baseline (T1), immediately after ANH (T2), and 1 hour and 2 hours after ANH (T3 and T4). Data were submitted to ANOVA for repeated measures followed by the Bonferroni test.


The cardiac index increased in GI after ANH (T2 and T3, P < 0.001). The mean arterial pressure was sustained in GI, but decreased after ANH in GII (T2, T3 and T4, P < 0.05). The right atrial pressure and pulmonary artery wedge pressure decreased in GI (T3 and T4, P < 0.05). The PPV increased in GII (T3 and T4, P < 0.001). The SPV increased in GI (T4, P < 0.05) and GII (T3 and T4, P < 0.001).


The fluid responsiveness evaluated by PPV and SPV, as well as the cardiac index and mean arterial pressure, in animals submitted to ANH with hydroxyethyl starch showed that the hemodynamics were better preserved. We can suppose that starch remains longer in the vessels when compared with normal saline solution.


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Supported by grants from FAPESP (06/55221-8). Performed at LIM08.

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Sant'Ana, A., Otsuki, D., Fantoni, D. et al. Evaluation of systolic pressure variation and pulse pressure variation in an experimental model of acute normovolemic hemodilution. Crit Care 12 (Suppl 2), P92 (2008).

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