ZVONÍČEK, Václav, Pavel JURAK, Josef HALAMEK, Peter KRUŽLIAK, Vlastimil VONDRA, Pavel LEINVEBER, Ivan ČUNDRLE, Martin PAVLÍK, Pavel SUK and Vladimír ŠRÁMEK. The impact of sedation on pulse pressure variation. Australian Critical Care. New York: Elsevier Science INC, 2015, vol. 28, No 4, p. 203-207. ISSN 1036-7314. Available from: https://dx.doi.org/10.1016/j.aucc.2015.02.004.
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Basic information
Original name The impact of sedation on pulse pressure variation
Authors ZVONÍČEK, Václav (203 Czech Republic, guarantor, belonging to the institution), Pavel JURAK (203 Czech Republic), Josef HALAMEK (203 Czech Republic), Peter KRUŽLIAK (203 Czech Republic), Vlastimil VONDRA (203 Czech Republic), Pavel LEINVEBER (203 Czech Republic), Ivan ČUNDRLE (203 Czech Republic, belonging to the institution), Martin PAVLÍK (203 Czech Republic), Pavel SUK (203 Czech Republic, belonging to the institution) and Vladimír ŠRÁMEK (203 Czech Republic, belonging to the institution).
Edition Australian Critical Care, New York, Elsevier Science INC, 2015, 1036-7314.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30200 3.2 Clinical medicine
Country of publisher United States of America
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.479
RIV identification code RIV/00216224:14110/15:00086623
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1016/j.aucc.2015.02.004
UT WoS 000364138700009
Keywords in English Pulse pressure variation; Sedation; Heart lung interactions; Mechanical ventilation; Brain death; Oesophageal pressure
Tags EL OK
Tags International impact, Reviewed
Changed by Changed by: Ing. Mgr. Věra Pospíšilíková, učo 9005. Changed: 16/2/2016 10:00.
Abstract
Objective: Pulse pressure variations (PPV) are mainly influenced by ventilation. The impact of sedation on PPV is not known. The aim of the study was to test the influence of sedation on pulse pressure variation in mechanically ventilated critically ill patients and to compare PPV in critically ill and brain dead patients. Beside the absolute value of PPV, the adjusted values of pulse pressure were used to eliminate influence of ventilation. Design and intervention: Mechanically ventilated patients received four different breath frequencies. At each frequency airway pressure was adjusted to keep the end-tidal CO2 stable. In critically ill patients the frequencies were applied at basal (bispectral index - BIS median 38) and deeper sedation (BIS 29). Main outcome measures: Simultaneous haemodynamic and respiratory data including oesophageal pressure were recorded, adjusted PPV were calculated as PPV/VT, PPV/dPair, PPV/dPes where VT is tidal volume, dPair and dPes are airway and oesophageal driving pressures. Setting: University Hospital, ICU. Participants: 30 critically ill and 23 patients with a diagnosis of brain death. Results: The pulse pressure variation did not change significantly during deep sedation compared to basal sedation (median 10.3 vs 10.9%) whereas PPV/dPair increased from 0.7 to 0.8%/cm H2O and PPV/dPes from 1.9%/ cm H2O to 2.4%/cm H2O (p = 0.04). Patients with a diagnosis of brain death had higher PPV and adjusted PPV than critically ill patients. Conclusion: Deeper sedation increases values of adjusted pulse pressure variation. (C) 2015 Australian College of Critical Care Nurses Ltd. Published by Elsevier Ltd. All rights reserved.
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