The impact of sedation on pulse pressure variation

J 2015

The impact of sedation on pulse pressure variation

ZVONÍČEK, Václav, Pavel JURAK, Josef HALAMEK, Peter KRUŽLIAK, Vlastimil VONDRA et. al.

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

Language

English

Type of outcome

Článek v odborném periodiku

Field of Study

30200 3.2 Clinical medicine

Country of publisher

United States of America

Confidentiality degree

není předmětem státního či obchodního tajemství

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

Abstract

V originále

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.

Citovat

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.

@article{1335887,
   author = {Zvoníček, Václav and Jurak, Pavel and Halamek, Josef and Kružliak, Peter and Vondra, Vlastimil and Leinveber, Pavel and Čundrle, Ivan and Pavlík, Martin and Suk, Pavel and Šrámek, Vladimír},
   article_location = {New York},
   article_number = {4},
   doi = {http://dx.doi.org/10.1016/j.aucc.2015.02.004},
   keywords = {Pulse pressure variation; Sedation; Heart lung interactions; Mechanical ventilation; Brain death; Oesophageal pressure},
   language = {eng},
   issn = {1036-7314},
   journal = {Australian Critical Care},
   title = {The impact of sedation on pulse pressure variation},
   volume = {28},
   year = {2015}
}

TY  - JOUR
ID  - 1335887
AU  - Zvoníček, Václav - Jurak, Pavel - Halamek, Josef - Kružliak, Peter - Vondra, Vlastimil - Leinveber, Pavel - Čundrle, Ivan - Pavlík, Martin - Suk, Pavel - Šrámek, Vladimír
PY  - 2015
TI  - The impact of sedation on pulse pressure variation
JF  - Australian Critical Care
VL  - 28
IS  - 4
SP  - 203-207
EP  - 203-207
PB  - Elsevier Science INC
SN  - 10367314
KW  - Pulse pressure variation
KW  - Sedation
KW  - Heart lung interactions
KW  - Mechanical ventilation
KW  - Brain death
KW  - Oesophageal pressure
N2  - 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.
ER  -

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. \textit{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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