Why the study?
How do arterial pulse pressure and stroke volume respond to a perturbation in left ventricular blood volume?
How do arterial pulse pressure and stroke volume respond to a perturbation in left ventricular blood volume?
Arterial pulse pressure is not linearly proportional to stroke volume and should be used with caution as a surrogate in guiding fluid therapy.
Pulse pressure underestimates relative stroke volume changes with LV volume shifts; hypothesis-generating for fluid responsiveness monitoring and requires clinical validation.
Arterial pulse pressure has been widely used as surrogate of stroke volume, for example, in the guidance of fluid therapy. However, recent experimental investigations suggest that arterial pulse pressure is not linearly proportional to stroke volume. However, mechanisms underlying the relation between the two have not been clearly understood. The goal of this study was to elucidate how arterial pulse pressure and stroke volume respond to a perturbation in the left ventricular blood volume based on a systematic mathematical analysis. Both our mathematical analysis and experimental data showed that the relative change in arterial pulse pressure due to a left ventricular blood volume perturbation was consistently smaller than the corresponding relative change in stroke volume, due to the nonlinear left ventricular pressure-volume relation during diastole that reduces the sensitivity of arterial pulse pressure to perturbations in the left ventricular blood volume. Therefore, arterial pulse pressure must be used with care when used as surrogate of stroke volume in guiding fluid therapy.
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Bighamian et al. (2014) studied this question.
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