Aalborg Hospital, Aarhus University Hospital, Aalborg, Denmark.
Acta Anaesthesiol Scand. 2010 Feb;54(2):199-205. doi: 10.1111/j.1399-6576.2009.02061.x. Epub 2009 Aug 13.
The respiratory variation in the pre-ejection period (Delta PEP) has been used to predict fluid responsiveness in mechanically ventilated patients. Recently, we automated this parameter and indexed it to tidal volume (PEPV) and showed that it was a reliable predictor for post-cardiac surgery, mainly paced, patients ventilated with low tidal volumes. The aims of the present animal study were to investigate PEPV's ability to predict fluid responsiveness under different fluid loading conditions and natural heart rates during low tidal volume ventilation (6 ml/kg) and to compare the performance of PEPV with other markers of fluid responsiveness.
Eight prone, anesthetized piglets (23-27 kg) ventilated with tidal volumes of 6 ml/kg were subjected to a sequence of 25% hypovolemia, normovolemia, and 25% and 50% hypervolemia. PEPV, Delta PEP, pulse pressure variation (PPV), central venous pressure (CVP), and pulmonary artery occlusion pressure (PAOP) were measured before each volume expansion.
Sensitivity was 89% and specificity was 93% for PEPV, 78% and 93% for Delta PEP, 89% and 100% for PPV, 78% and 93% for CVP, and 89% and 87% for PAOP.
PEPV predicts fluid responsiveness in low tidal volume ventilated piglets.
射前期呼吸变异（Delta PEP）已被用于预测机械通气患者的液体反应性。最近，我们对该参数进行了自动化处理，并将其与潮气量（PEPV）相关联，结果表明它是预测心脏手术后主要起搏、低潮气量通气患者液体反应性的可靠指标。本动物研究的目的是在低潮气量通气（6ml/kg）下，不同液体负荷条件和自然心率下，研究 PEPV 预测液体反应性的能力，并比较 PEPV 与其他液体反应性指标的性能。
8 头侧卧麻醉猪（23-27kg），潮气量为 6ml/kg，先后接受 25%低血容量、正常血容量和 25%、50%高血容量。在每次容量扩张前测量 PEPV、Delta PEP、脉搏压变异（PPV）、中心静脉压（CVP）和肺动脉闭塞压（PAOP）。
PEPV 的敏感性为 89%，特异性为 93%，Delta PEP 为 78%，特异性为 93%，PPV 为 89%，特异性为 100%，CVP 为 78%，特异性为 93%，PAOP 为 89%，特异性为 87%。
PEPV 可预测低潮气量通气猪的液体反应性。
