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03219pab a2200241 454500 |
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161010b2016 xxu||||| |||| 00| 0 eng d |
| 100 ## - MAIN ENTRY--PERSONAL NAME |
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| Personal name |
Myatra SN |
| 245 ## - TITLE STATEMENT |
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| Title |
The Changes in Pulse Pressure Variation or Stroke Volume Variation After a "Tidal Volume Challenge" Reliably Predict Fluid Responsiveness During Low Tidal Volume Ventilation |
| 260 ## - PUBLICATION, DISTRIBUTION, ETC. (IMPRINT) |
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| Place of publication, distribution, etc |
Philadelphia PA |
| Name of publisher, distributor, etc |
Lippincott Williams & Wilkins |
| Date of publication, distribution, etc |
2016 |
| 300 ## - PHYSICAL DESCRIPTION |
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| Extent |
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| 520 ## - SUMMARY, ETC. |
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| Summary, etc |
OBJECTIVES: Stroke volume variation and pulse pressure variation do not reliably predict fluid responsiveness during low tidal volume ventilation. We hypothesized that with transient increase in tidal volume from 6 to 8 mL/kg predicted body weight, that is, "tidal volume challenge," the changes in pulse pressure variation and stroke volume variation will predict fluid responsiveness. DESIGN: Prospective, single-arm study. SETTING: Medical-surgical ICU in a university hospital. PATIENTS: Adult patients with acute circulatory failure, having continuous cardiac output monitoring, and receiving controlled low tidal volume ventilation. INTERVENTIONS: The pulse pressure variation, stroke volume variation, and cardiac index were recorded at tidal volume 6 mL/kg predicted body weight and 1 minute after the "tidal volume challenge." The tidal volume was reduced back to 6 mL/kg predicted body weight, and a fluid bolus was given to identify fluid responders (increase in cardiac index > 15%). The end-expiratory occlusion test was performed at tidal volumes 6 and 8 mL/kg predicted body weight and after reducing tidal volume back to 6 mL/kg predicted body weight. RESULTS: Thirty measurements were obtained in 20 patients. The absolute change in pulse pressure variation and stroke volume variation after increasing tidal volume from 6 to 8 mL/kg predicted body weight predicted fluid responsiveness with areas under the receiver operating characteristic curves (with 95% CIs) being 0.99 (0.98-1.00) and 0.97 (0.92-1.00), respectively. The best cutoff values of the absolute change in pulse pressure variation and stroke volume variation after increasing tidal volume from 6 to 8 mL/kg predicted body weight were 3.5% and 2.5%, respectively. The pulse pressure variation, stroke volume variation, central venous pressure, and end-expiratory occlusion test obtained during tidal volume 6 mL/kg predicted body weight did not predict fluid responsiveness. CONCLUSIONS: The changes in pulse pressure variation or stroke volume variation obtained by transiently increasing tidal volume (tidal volume challenge) are superior to pulse pressure variation and stroke volume variation in predicting fluid responsiveness during low tidal volume ventilation. |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Location of event |
Low Tidal Volume Ventilation |
| 650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM |
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| Location of event |
Pulse Pressure Variation |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Personal name |
Teboul JL |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Personal name |
Kulkarni AP |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Personal name |
Monnet X |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Personal name |
Divatia JV |
| 700 ## - ADDED ENTRY--PERSONAL NAME |
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| Personal name |
Prabu NR |
| 773 ## - HOST ITEM ENTRY |
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| Main entry heading |
Critical Care Medicine |
| Place, publisher, and date of publication |
Philadelphia PA : Lippincott Williams & Wilkins, 2017 |
| International Standard Serial Number |
1530-0293 |
| Relationship information |
Vol. 45, no.3, p.415-421. |
| 856 ## - ELECTRONIC LOCATION AND ACCESS |
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| Uniform Resource Identifier |
http://10.3.0.2/mm01/Articles/AR17904.pdf |
| Materials specified |
PDF |
| 906 ## - LOCAL DATA ELEMENT F, LDF (RLIN) |
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| Added Entry |
TMH |
| Dept |
Anaesthesiology |
| Corporate name |
TMC |
| PMID |
27922879 |
| Article Type |
Journal Article |
| Country type |
International |
| 942 ## - ADDED ENTRY ELEMENTS (KOHA) |
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| Source of classification or shelving scheme |
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| Item type |
Articles |
