The Changes in Pulse Pressure Variation or Stroke Volume Variation After a "Tidal Volume Challenge" Reliably Predict Fluid Responsiveness During Low Tidal Volume Ventilation (Record no. 81363)

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fixed length control field 03219pab a2200241 454500
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fixed length control field 161010b2016 xxu||||| |||| 00| 0 eng d
100 ## - MAIN ENTRY--PERSONAL NAME
Personal name Myatra SN
245 ## - TITLE STATEMENT
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)
Place of publication, distribution, etc Philadelphia PA
Name of publisher, distributor, etc Lippincott Williams & Wilkins
Date of publication, distribution, etc 2016
300 ## - PHYSICAL DESCRIPTION
Extent
520 ## - SUMMARY, ETC.
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
Location of event Low Tidal Volume Ventilation
650 ## - SUBJECT ADDED ENTRY--TOPICAL TERM
Location of event Pulse Pressure Variation
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Teboul JL
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Kulkarni AP
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Monnet X
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Divatia JV
700 ## - ADDED ENTRY--PERSONAL NAME
Personal name Prabu NR
773 ## - HOST ITEM ENTRY
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
Uniform Resource Identifier http://10.3.0.2/mm01/Articles/AR17904.pdf
Materials specified PDF
906 ## - LOCAL DATA ELEMENT F, LDF (RLIN)
Added Entry TMH
Dept Anaesthesiology
Corporate name TMC
PMID 27922879
Article Type Journal Article
Country type International
942 ## - ADDED ENTRY ELEMENTS (KOHA)
Source of classification or shelving scheme
Item type Articles
Holdings
Withdrawn status Lost status Damaged status Not for loan Permanent location Current location Date acquired Barcode Date last seen Koha item type
        Tata Memorial Hospital Tata Memorial Hospital 2017-01-19 AR17904 2017-01-19 Articles

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