Systolic pressure variation (Deltadown) can guide fluid therapy during pheochromocytoma surgery: (La variation de la pression systolique (Deltadown) peut guider le remplissage vasculaire pendant la resection d'un pheochromocytome).

摘要

PURPOSE: To date, no monitoring has proved its usefulness for both interpretation and treatment of arterial hypotension following pheochromocytoma resection. In this prospective observational study, we measured the negative component (Deltadown) of the respiratory systolic pressure variation in order to assess its ability to guide fluid therapy in 13 patients undergoing pheochromocytoma surgery. METHODS: The arterial pressure waveform was recorded via a 20-g radial artery catheter. Deltadown was measured during abdominal exploration (baseline), after fluid loading, before and following tumour resection, and during treatment of arterial hypotension. RESULTS: At baseline, Deltadown ranged between 1 and 15 mmHg (median: 3 mmHg). Volume loading (500 mL colloid over 20 min) performed during abdominal exploration significantly reduced Deltadown (P = 0.001) and resulted in Deltadown values