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Implications of arterial pressure variation in patients in the intensive care unit

Gunn, SR and Pinsky, MR (2001) Implications of arterial pressure variation in patients in the intensive care unit. Current Opinion in Critical Care, 7 (3). 212 - 217. ISSN 1070-5295

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Positive-pressure ventilation alters stroke volume by transiently increasing intrathoracic pressure and thereby decreasing preload. This phasic variation in stroke volume results in a cyclic fluctuation in arterial pressure with a phase length equal to the respiratory rate. Measuring ventilation-induced arterial pressure variation allows the clinician to predict the cardiovascular response to changes in intravascular volume status. Thus, one may predict preload responsiveness because the greater the amount of ventilation-associated arterial pressure variation, the greater the patient's preload responsiveness. This variation in arterial pressure can been defined as a variation in either systolic pressure or pulse pressure. Although pulse pressure gives a clearer signal, systolic pressure variation may be easier to measure bedside without invasive hemodynamic monitoring. Newer methods of quantifying this arterial pressure variation include the respiratory systolic variation test, which can performed without an apneic baseline, and the pulse pressure variation, a potentially more accurate measure of preload responsiveness. © 2001 Lippincott Williams & Wilkins, Inc.


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Item Type: Article
Status: Published
CreatorsEmailPitt UsernameORCID
Gunn, SRsrgst26@pitt.eduSRGST260000-0002-6599-2018
Pinsky, MRpinsky@pitt.eduPINSKY0000-0001-6166-700X
Date: 3 July 2001
Date Type: Publication
Journal or Publication Title: Current Opinion in Critical Care
Volume: 7
Number: 3
Page Range: 212 - 217
DOI or Unique Handle: 10.1097/00075198-200106000-00012
Refereed: Yes
ISSN: 1070-5295
Article Type: Review
PubMed ID: 11436530
Date Deposited: 14 Jul 2012 14:35
Last Modified: 27 Aug 2020 15:55


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