Decreased lung compliance increases preload dynamic tests in a pediatric acute lung injury model
Fecha
2015
Autores
Erranz, Benjamín
Díaz, Franco
Donoso, Alejandro
Salomón, Tatiana
Carvajal, Cristóbal
Torres, María Fernanda
Cruces, Pablo
Título de la revista
ISSN de la revista
Título del volumen
Editor
Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U.
Resumen
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±0.4kg) were anesthetized, paralyzed and monitored with pulse contour analysis. PPV and SVV were recorded during mechanical ventilation with a VT of 6 and 12mL/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.
Descripción
Centro de Medicina Regenerativa
Palabras clave
Hemodynamics , Preload , Acute lung injury , Mechanical ventilation , Pediatric
Citación
Revista Chilena de Pediatría, November–December 2015, vol. 86, n°6, p.404–409