Is the pulse pressure variation a good predictor of fluid responsiveness in mechanically ventilated patients with low tidal volume?
© Costa et al; licensee BioMed Central Ltd. 2009
Published: 13 March 2009
A transversal and interventional study that included 30 critically ill patients with acute circulatory failure, sedated and mechanically ventilated with a tidal volume of 6 to 7 ml/kg. Mechanical ventilatory measurements including positive end-expiratory pressure plateau and peak pressures, static compliance and hemodynamic measurements including PPV, heart rate, mean systemic and pulmonary arterial pressures, central venous pressure, pulmonary capillary wedge pressure and cardiac index were obtained before and after fluid challenge, performed with 1,000 ml crystalloids or 500 ml colloids. Fluid responsiveness was defined as an increase in cardiac index of at least 15%.
The baseline PPV is a good predictor of fluid responsiveness in mechanically ventilated patients with low tidal volume. The threshold value of 10% was associated with a significant increase in cardiac index after volume expansion.
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