On-line measurement of systolic pressure variation and pulse pressure variation on a multiparametric monitor.

摘要

In critically ill ventilated patients the use of cardiac filling pressures is poorly related to volume expansion efficacy . Many studies have demonstrated the usefulness of dynamic indices based on heart-lung interaction, such as systolic pressure variation (SPV) and pulse pressure variation (PPV) , in identifyingpatients who may benefit from volume loading .One of the major concerns with the use of these dynamic indices is that they have so far been always calculated off-line, making them of little use in the everyday clinical assessmentof circulatory status. Recently Gouvea et al. proposed a new, but still not validated, technique to quantify the effects of mechanical ventilation on the arterial pressure curve using nothing but a standard multiparametric monitor. Briefly, a monitor that plots pulmonary artery wedge pressure curve together with a ventilatory curve allows, by applying this function to the systemic blood pressure, on-line analysis of the respiratory variations in pulse and arterial blood pressure.