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Ventilation‐induced variation in the arterially determined isovolumic contraction period is an excellent indicator of hemorrhagic shock
Author(s) -
Houwelingen Marc,
Merkus Daphne,
Hofland Jan,
Tenbrinck Robert,
Hekkert Maaike te Lintel,
Dijk Geert,
Hoeks Arnold P.G.,
Duncker Dirk J.
Publication year - 2011
Publication title -
the faseb journal
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.709
H-Index - 277
eISSN - 1530-6860
pISSN - 0892-6638
DOI - 10.1096/fasebj.25.1_supplement.lb469
Subject(s) - medicine , coefficient of variation , contraction (grammar) , ventilation (architecture) , shock (circulatory) , hemorrhagic shock , anesthesia , pulse pressure , mechanical ventilation , analysis of variance , cardiology , blood pressure , chemistry , physics , thermodynamics , chromatography
The ventilation‐induced relative variation in pre‐ejection period (ΔPEP) has recently been shown to predict fluid responsiveness in patients in shock. We hypothesized that the ventilatory variation in isovolumic contraction period determined by central arterial pulse wave analysis (ΔAIC) is a more sensitive predictor than the peripherally assessed ΔPEP which is influenced by pulse wave travel time and ventricular electro‐mechanical delay. To test this hypothesis we studied the responses of ΔAIC and ΔPEP to a graded hemorrhage protocol, and compared these to the response of the clinically well known pulse pressure variation (ΔPP), which has a high predictive value for fluid responsiveness. A graded hemorrhage protocol (blood withdrawal up to 20ml/kg) was instituted in 7 anesthetized Yorkshire X Landrace pigs. ΔAIC correlated well with ΔPP (r = 0.86, p<0.001) and ΔPEP (r = 0.84, p<0.001). Moreover, the coefficient of variation of ΔAIC (0.50) was found to be significantly lower than that of ΔPEP (0.94, p=0.04). Conclusions ΔAIC can be used to assess the level of hemorrhagic shock in a swine model and appears to be a more sensitive predictor of fluid responsiveness than ΔPEP.