Pulse-pressure variation and hemodynamic response in patients with elevated pulmonary artery pressure: a clinical study
Why the study?
Does pulse-pressure variation predict volume responsiveness in patients with elevated pulmonary artery pressure?
Population
22 patients with elevated pulmonary artery pressure, comprising 15 cardiac surgery patients and 7 septic…
Design
Cohort
Follow-up
Immediate (before and after fluid challenges)
Authors
Discussion
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Member takes
Implication
PPV should not guide fluid decisions in elevated PAP; observational data leave open mechanisms like RV dysfunction and require prospective validation.
Structured PICO
Does pulse-pressure variation predict volume responsiveness in patients with elevated pulmonary artery pressure?
P
Population
22 patients with elevated pulmonary artery pressure, comprising 15 cardiac surgery patients (mean pulmonary artery pressure 27 +/- 5 mm Hg) and 7 septic shock patients (mean pulmonary artery pressure 33 +/- 10 mm Hg).
I
Intervention
Fluid challenge with 200 ml hydroxyethyl starch boli ordered on clinical indication.
O
Outcome
Prediction of volume responsiveness (defined as stroke volume increase > 10%) using pulse-pressure variation (PPV).surrogate
In patients with elevated pulmonary artery pressure, pulse-pressure variation is a poor predictor of fluid responsiveness, likely due to right ventricular dysfunction.
Cite This Study
Ballmoos et al. (2010) studied this question.