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2013, Number 1

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Med Crit 2013; 27 (1)

Modification of stroke volume variation with increased intra-abdominal pressure in normovolemic porcine model

Deloya TE, Poblano MM, Hernández LD, Tendillo F, Jiménez F, Lomelí TJM, Martínez MJJ, Mondragón LT

Language: Spanish
References: 29
Page: 25-32
PDF size: 95.52 Kb.


ABSTRACT

Introduction: The monitoring of the critically ill patient is essential to assess their physiological conditions. In most cases, hemodynamic monitoring is useful because it focuses on tissue perfusion, especially in the context to continue resuscitation. A current issue is whether or not there is a response to fluid management. The pulse pressure variation and the stroke volume variation have demonstrated improved sensitivity and specificity to predict fluid response. The intra-abdominal hypertension produced hemodynamic changes with impact in stroke volume. Objectives: To analyze the stroke volume variation in different levels of intra-abdominal pressure in normovolemic porcine models. Methods: We used three pigs, York-Landrace 50-50. An intraperitoneal catheter was placed and saline 0.9% infused to increase intra-abdominal pressure. The intra-abdominal pressure baseline was 5 mmHg with increased intra-abdominal pressure 5 mmHg every 10 minutes up to 30 mmHg. We obtained measurements with the system FloTrac–Vigileo Edwars Lifesciences™. The stroke volume variation was measured. Statistical analysis was performed by analysis of variance, considering significant p less than 0.05. We used the SPSS v.19. Results: 180 measurements were performed. We found significative differences with an increase in the intraabdominal pressure at 15 mmHg and above. The increase in intraabdominal pressure above 15 mmHg produces changes in stroke volume variation without a direct relation with the intravascular volume. Conclusions: Increased intra-abdominal pressure progressively increases stroke volume variability in normovolemic pigs. Intra-abdominal hypertension is a factor that modifies the stroke volume variation; so that its interpretation should be cautious in the presence of this pathology.


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