Department of Emergency Medicine, Kwan Dong University, Seoul, Korea.
Crit Care Resusc. 2011 Sep;13(3):156-61.
A pulse pressure variation (PPV) ≥ 13% of mean arterial pressure (MAP) is an accepted marker of a fluid-responsive state. However, there is no study of its epidemiology and associations among non-cardiac critically ill patients.
To conduct a pilot study of the epidemiology and associations of a PPV ≥ 13% among non-cardiac critically ill patients.
Prospective observational study.
Intensive care unit of a university hospital.
Cohort of 37 sedated critically ill patients undergoing mandatory ventilation.
PPV values, tidal volume and peak airway pressure, MAP, heart rate (HR) and central venous pressure (CVP) collected every 15 minutes; fluid balance collected hourly; correlation between PPV and these variables.
450 PPV measurements were collated. The PPV value was ≥ 13% in 86 (19%) measurements and was observed in two consecutive measurements in 68 (15%) of cases. On multivariable analysis, mean PPV was significantly correlated with CVP (P=0.04), HR (P<0.001) and peak airway pressure (P=0.001), but not fluid balance (P=0.3).
Among non-cardiac surgery mechanically ventilated patients, a PPV in the fluid-responsive range was present in one-fifth of measurements and showed logical correlations with relevant haemodynamic and mechanical ventilation-related variables. Our results provide a rationale for a more comprehensive evaluation of PPV measurement in suitable critically ill patients.
脉压变化（PPV）≥平均动脉压（MAP）的 13%是液体反应状态的公认标志物。然而，目前尚无关于非心脏危重病患者中其流行病学和相关性的研究。
对非心脏危重病患者中 PPV≥13%的流行病学和相关性进行初步研究。
前瞻性观察性研究。
大学医院的重症监护病房。
接受强制性通气的镇静危重病患者队列，共 37 例。
每 15 分钟收集一次 PPV 值、潮气量和气道峰压、MAP、心率（HR）和中心静脉压（CVP）；每小时收集一次液体平衡；PPV 与这些变量之间的相关性。
共收集了 450 次 PPV 测量值。在 86 次（19%）测量中，PPV 值≥13%，在 68 次（15%）连续两次测量中观察到该值。多变量分析显示，平均 PPV 与 CVP（P=0.04）、HR（P<0.001）和气道峰压（P=0.001）显著相关，但与液体平衡（P=0.3）无关。
在非心脏手术机械通气患者中，有五分之一的测量值处于液体反应范围内的 PPV，并与相关的血流动力学和机械通气相关变量存在合理的相关性。我们的研究结果为在合适的危重病患者中更全面地评估 PPV 测量提供了依据。
