Faculdade de Medicina, Universidade Estadual Paulista (UNESP), Botucatu, Brazil.
Faculdade de Medicina, Universidade Estadual Paulista (UNESP), Botucatu, Brazil; Faculdade de Medicina Veterinária e Zootecnia, Universidade Estadual Paulista (UNESP), Botucatu, Brazil.
Vet Anaesth Analg. 2021 Jul;48(4):501-508. doi: 10.1016/j.vaa.2021.01.009. Epub 2021 Apr 3.
To compare pulse pressure variation (PPV) and systolic pressure variation (SPV) measured from a peripheral artery to predict fluid responsiveness in anesthetized healthy dogs.
Prospective study.
A total of 39 dogs (13.8-26.8 kg) anesthetized with isoflurane for elective ovariohysterectomy.
Ventilation was controlled (tidal volume 12 mL kg; 40% inspiratory pause). PPV and SPV were recorded from a dorsal pedal artery catheter using an automated algorithm. A fluid challenge (FC) with lactated Ringer's solution (20 mL kg over 15 minutes) was administered once (21 animals) or twice (18 animals) before surgery. Increases in transpulmonary thermodilution stroke volume index > 15% from values recorded before each FC defined responders to volume expansion. Final fluid responsiveness status was based on the response to single FC or second FC. Predictive ability of PPV and SPV was compared by receiver operating characteristic (ROC) curve analysis and by the range of cut-off values associated with uncertain results (gray zone).
All animals after the single FC were responders; all animals administered two FCs were nonresponders after the second FC. The area under the ROC curve (AUROC) of PPV (0.968) did not differ from that of SPV (0.937) (p = 0.45). Best cut-off thresholds to discriminate responders from nonresponders were >11.7% (PPV) and >7.4 mmHg (SPV). The gray zone of PPV and SPV was 8.2-14.6% and 7.0-7.4 mmHg, respectively. The percentage of animals with PPV and SPV values within the gray zone was less for SPV (10.2%) than for PPV (30.8%).
PPV and SPV obtained from the dorsal pedal artery are useful predictors of fluid responsiveness in dogs. Using an automated algorithm, SPV may more accurately predict fluid responsiveness than PPV, with responders identifiable by PPV > 14.6% and SPV > 7.4 mmHg.
比较外周动脉测量的脉压变异（PPV）和收缩压变异（SPV）预测麻醉健康犬液体反应性。
前瞻性研究。
共 39 只麻醉下接受择期卵巢子宫切除术的犬（13.8-26.8kg），使用异氟醚。
控制通气（潮气量 12ml/kg；40%吸气暂停）。使用自动算法从背侧足动脉导管记录 PPV 和 SPV。在手术前，给予乳酸林格氏液（20ml/kg，15 分钟内输注）一次（21 只动物）或两次（18 只动物）液体负荷。每次 FC 前后，经肺温度稀释心排量指数增加>15%定义为对容量扩张有反应。最终的液体反应性状态基于单次 FC 或第二次 FC 的反应。通过接收者操作特性（ROC）曲线分析和与不确定结果（灰色区域）相关的截断值范围比较 PPV 和 SPV 的预测能力。
单次 FC 后所有动物均为反应者；第二次 FC 后所有接受两次 FC 的动物均为无反应者。PPV 的 ROC 曲线下面积（AUROC）与 SPV（0.937）无差异（p=0.45）。区分反应者和无反应者的最佳截断值为>11.7%（PPV）和>7.4mmHg（SPV）。PPV 和 SPV 的灰色区域分别为 8.2-14.6%和 7.0-7.4mmHg。PPV 和 SPV 值处于灰色区域的动物百分比，SPV（10.2%）低于 PPV（30.8%）。
背侧足动脉获得的 PPV 和 SPV 是犬液体反应性的有用预测指标。使用自动算法，SPV 比 PPV 更能准确预测液体反应性，PPV>14.6%和 SPV>7.4mmHg 可识别反应者。
