TY - JOUR
T1 - Decreased lung compliance increases preload dynamic tests in a pediatric acute lung injury model
AU - Erranz, Benjamín
AU - Díaz, Franco
AU - Donoso, Alejandro
AU - Salomón, Tatiana
AU - Carvajal, Cristóbal
AU - Torres, María Fernanda
AU - Cruces, Pablo
N1 - Funding Information:
This work was supported by grant Fondecyt 11075041 from CONICYT (Comisión Nacional de Investigación Científica y Tecnológica, Chile) to Pablo Cruces.
Publisher Copyright:
© 2015 Sociedad Chilena de Pediatría. Published by Elsevier España, S.L.U.
PY - 2015/11/1
Y1 - 2015/11/1
N2 - Background Preload dynamic tests, pulse pressure variation (PPV) and stroke volume variation (SVV) have emerged as powerful tools to predict response to fluid administration. The influence of factors other than preload in dynamic preload test is currently poorly understood in pediatrics. The aim of our study was to assess the effect of tidal volume (VT) on PPV and SVV in the context of normal and reduced lung compliance in a piglet model. Material and method Twenty large-white piglets (5.2 ± 0.4 kg) were anesthetized, paralyzed and monitored with pulse contour analysis. PPV and SVV were recorded during mechanical ventilation with a VT of 6 and 12 mL/kg (low and high VT, respectively), both before and after tracheal instillation of polysorbate 20. Results Before acute lung injury (ALI) induction, modifications of VT did not significantly change PPV and SVV readings. After ALI, PPV and SVV were significantly greater during ventilation with a high VT compared to a low VT (PPV increased from 8.9 ± 1.2 to 12.4 ± 1.1%, and SVV from 8.5 ± 1.0 to 12.7 ± 1.2%, both P < 0.01). Conclusions This study found that a high VT and reduced lung compliance due to ALI increase preload dynamic tests, with a greater influence of the latter. In subjects with ALI, lung compliance should be considered when interpreting the preload dynamic tests.
AB - Background Preload dynamic tests, pulse pressure variation (PPV) and stroke volume variation (SVV) have emerged as powerful tools to predict response to fluid administration. The influence of factors other than preload in dynamic preload test is currently poorly understood in pediatrics. The aim of our study was to assess the effect of tidal volume (VT) on PPV and SVV in the context of normal and reduced lung compliance in a piglet model. Material and method Twenty large-white piglets (5.2 ± 0.4 kg) were anesthetized, paralyzed and monitored with pulse contour analysis. PPV and SVV were recorded during mechanical ventilation with a VT of 6 and 12 mL/kg (low and high VT, respectively), both before and after tracheal instillation of polysorbate 20. Results Before acute lung injury (ALI) induction, modifications of VT did not significantly change PPV and SVV readings. After ALI, PPV and SVV were significantly greater during ventilation with a high VT compared to a low VT (PPV increased from 8.9 ± 1.2 to 12.4 ± 1.1%, and SVV from 8.5 ± 1.0 to 12.7 ± 1.2%, both P < 0.01). Conclusions This study found that a high VT and reduced lung compliance due to ALI increase preload dynamic tests, with a greater influence of the latter. In subjects with ALI, lung compliance should be considered when interpreting the preload dynamic tests.
KW - Acute lung injury
KW - Hemodynamics
KW - Mechanical ventilation
KW - Pediatric
KW - Preload
UR - http://www.scopus.com/inward/record.url?scp=84949562643&partnerID=8YFLogxK
U2 - 10.1016/j.rchipe.2015.06.023
DO - 10.1016/j.rchipe.2015.06.023
M3 - Article
C2 - 26471316
AN - SCOPUS:84949562643
SN - 0370-4106
VL - 86
SP - 404
EP - 409
JO - Revista Chilena de Pediatria
JF - Revista Chilena de Pediatria
IS - 6
ER -