Decreased lung compliance increases preload dynamic tests in a pediatric acute lung injury model
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 w...
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| Veröffentlicht in: | Revista Chilena de pediatría 2015-11, Vol.86 (6), p.404-409 |
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| description | 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.
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.
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 |
| doi_str_mv | 10.1016/j.rchipe.2015.06.023 |
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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.
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).
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.
Test dinámicos de precarga, variación de presión de pulso (PPV) y variación de volumen sistólico (SVV) han emergido como herramientas poderosas para predecir respuesta a la administración de fluidos. Actualmente la influencia de factores distintos a la precarga en la determinación de los test dinámicos de precarga es pobremente conocida en pediatría. Nuestro objetivo fue medir el efecto del volumen tidal (VT) sobre PPV y SVV en un contexto de compliance pulmonar normal y disminuida en un modelo porcino.
Veinte cerditos Large-White anestesiados y paralizados (5,2±0,4kg). PPV y SVV fueron medidos por análisis de contorno de pulso durante ventilación con VT de 6 y 12mL/kg (VT bajo y alto, respectivamente), ambos previo y posterior a lesión pulmonar aguda (ALI) químicamente inducida con instilación traqueal de polisorbato 20.
Previo a inducción de ALI, PPV y SVV no tuvieron cambios significativos al modificar el VT. Sin embargo, después de ALI, PPV y SVV fueron significativamente mayores durante ventilación con VT alto, respecto a VT bajo (PPV aumentó de 8,9±1,2 a 12,4±1,1%, y SVV de 8,5±1,0 a 12,7±1,2%, ambos P<0,01).
Este estudio encontró que un VT alto y una compliance pulmonar disminuida debido a ALI incrementan los test dinámicos de precarga, con una mayor influencia de esta última. En sujetos con ALI la compliance pulmonar debiera ser considerada al interpretar los test dinámicos de precarga.</description><identifier>ISSN: 0370-4106</identifier><identifier>EISSN: 0717-6228</identifier><identifier>DOI: 10.1016/j.rchipe.2015.06.023</identifier><identifier>PMID: 26471316</identifier><language>eng</language><publisher>Chile: Elsevier España, S.L.U</publisher><subject>Acute lung injury ; Acute Lung Injury - physiopathology ; Animals ; Blood Pressure - physiology ; Disease Models, Animal ; Fluid Therapy - methods ; Hemodinamia ; Hemodynamics ; Lesión Pulmonar Aguda ; Lung Compliance - physiology ; Mechanical ventilation ; Pediatric ; PEDIATRICS ; Pediatría ; Precarga ; Preload ; Respiration, Artificial - methods ; Stroke Volume - physiology ; Swine ; Tidal Volume - physiology ; Ventilación Mecánica</subject><ispartof>Revista Chilena de pediatría, 2015-11, Vol.86 (6), p.404-409</ispartof><rights>2015 Sociedad Chilena de Pediatría</rights><rights>Copyright © 2015 Sociedad Chilena de Pediatría. Publicado por Elsevier España, S.L.U. All rights reserved.</rights><rights>This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.</rights><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c447t-f4aea87424da7de75ffc485d27ea86470e487f01b82f62b3f57d3647d2ac1f083</citedby><cites>FETCH-LOGICAL-c447t-f4aea87424da7de75ffc485d27ea86470e487f01b82f62b3f57d3647d2ac1f083</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>230,314,776,780,881,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/26471316$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Erranz, Benjamín</creatorcontrib><creatorcontrib>Díaz, Franco</creatorcontrib><creatorcontrib>Donoso, Alejandro</creatorcontrib><creatorcontrib>Salomón, Tatiana</creatorcontrib><creatorcontrib>Carvajal, Cristóbal</creatorcontrib><creatorcontrib>Torres, María Fernanda</creatorcontrib><creatorcontrib>Cruces, Pablo</creatorcontrib><title>Decreased lung compliance increases preload dynamic tests in a pediatric acute lung injury model</title><title>Revista Chilena de pediatría</title><addtitle>Rev Chil Pediatr</addtitle><description>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.
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.
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).
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.
Test dinámicos de precarga, variación de presión de pulso (PPV) y variación de volumen sistólico (SVV) han emergido como herramientas poderosas para predecir respuesta a la administración de fluidos. Actualmente la influencia de factores distintos a la precarga en la determinación de los test dinámicos de precarga es pobremente conocida en pediatría. Nuestro objetivo fue medir el efecto del volumen tidal (VT) sobre PPV y SVV en un contexto de compliance pulmonar normal y disminuida en un modelo porcino.
Veinte cerditos Large-White anestesiados y paralizados (5,2±0,4kg). PPV y SVV fueron medidos por análisis de contorno de pulso durante ventilación con VT de 6 y 12mL/kg (VT bajo y alto, respectivamente), ambos previo y posterior a lesión pulmonar aguda (ALI) químicamente inducida con instilación traqueal de polisorbato 20.
Previo a inducción de ALI, PPV y SVV no tuvieron cambios significativos al modificar el VT. Sin embargo, después de ALI, PPV y SVV fueron significativamente mayores durante ventilación con VT alto, respecto a VT bajo (PPV aumentó de 8,9±1,2 a 12,4±1,1%, y SVV de 8,5±1,0 a 12,7±1,2%, ambos P<0,01).
Este estudio encontró que un VT alto y una compliance pulmonar disminuida debido a ALI incrementan los test dinámicos de precarga, con una mayor influencia de esta última. En sujetos con ALI la compliance pulmonar debiera ser considerada al interpretar los test dinámicos de precarga.</description><subject>Acute lung injury</subject><subject>Acute Lung Injury - physiopathology</subject><subject>Animals</subject><subject>Blood Pressure - physiology</subject><subject>Disease Models, Animal</subject><subject>Fluid Therapy - methods</subject><subject>Hemodinamia</subject><subject>Hemodynamics</subject><subject>Lesión Pulmonar Aguda</subject><subject>Lung Compliance - physiology</subject><subject>Mechanical ventilation</subject><subject>Pediatric</subject><subject>PEDIATRICS</subject><subject>Pediatría</subject><subject>Precarga</subject><subject>Preload</subject><subject>Respiration, Artificial - methods</subject><subject>Stroke Volume - physiology</subject><subject>Swine</subject><subject>Tidal Volume - physiology</subject><subject>Ventilación Mecánica</subject><issn>0370-4106</issn><issn>0717-6228</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2015</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp9kMtu3iAQhVHUKPc3qCJewM6AMXhVKUqaixQpiyRrwg9DguWbwK70v32wnHbZBQKdmTNz-Aj5yaBkwORVW0b7GSYsObC6BFkCrw7ICSimCsl58yO_KwWFYCCPyWlKLQBXktVH5JhLoVjF5Al5v0Ub0SR0tFuGD2rHfuqCGSzSMGyVRKeI3WgcdfvB9MHSGdOccp0aOqELZo5ZNHaZcRsShnaJe9qPDrtzcuhNl_Di-z4jb3e_X28eiqfn-8eb66fCCqHmwguDplGCC2eUQ1V7b0VTO66ynNMCikZ5YLuGe8l3la-Vq7LuuLHMQ1OdkXKbm2zIaXU7LnHIC_XLSkGvFFZQACDzgTobxGawcUwpotdTDL2Je81Ar4R1qzfCejVqkDoTzrbLzTYtux7dP9NfpLnh19aA-bd_Aka9JspAXYhoZ-3G8P8NX6k0jUI</recordid><startdate>20151101</startdate><enddate>20151101</enddate><creator>Erranz, Benjamín</creator><creator>Díaz, Franco</creator><creator>Donoso, Alejandro</creator><creator>Salomón, Tatiana</creator><creator>Carvajal, Cristóbal</creator><creator>Torres, María Fernanda</creator><creator>Cruces, Pablo</creator><general>Elsevier España, S.L.U</general><general>Sociedad Chilena de Pediatría</general><scope>6I.</scope><scope>AAFTH</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>GPN</scope></search><sort><creationdate>20151101</creationdate><title>Decreased lung compliance increases preload dynamic tests in a pediatric acute lung injury model</title><author>Erranz, Benjamín ; Díaz, Franco ; Donoso, Alejandro ; Salomón, Tatiana ; Carvajal, Cristóbal ; Torres, María Fernanda ; Cruces, Pablo</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c447t-f4aea87424da7de75ffc485d27ea86470e487f01b82f62b3f57d3647d2ac1f083</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2015</creationdate><topic>Acute lung injury</topic><topic>Acute Lung Injury - physiopathology</topic><topic>Animals</topic><topic>Blood Pressure - physiology</topic><topic>Disease Models, Animal</topic><topic>Fluid Therapy - methods</topic><topic>Hemodinamia</topic><topic>Hemodynamics</topic><topic>Lesión Pulmonar Aguda</topic><topic>Lung Compliance - physiology</topic><topic>Mechanical ventilation</topic><topic>Pediatric</topic><topic>PEDIATRICS</topic><topic>Pediatría</topic><topic>Precarga</topic><topic>Preload</topic><topic>Respiration, Artificial - methods</topic><topic>Stroke Volume - physiology</topic><topic>Swine</topic><topic>Tidal Volume - physiology</topic><topic>Ventilación Mecánica</topic><toplevel>online_resources</toplevel><creatorcontrib>Erranz, Benjamín</creatorcontrib><creatorcontrib>Díaz, Franco</creatorcontrib><creatorcontrib>Donoso, Alejandro</creatorcontrib><creatorcontrib>Salomón, Tatiana</creatorcontrib><creatorcontrib>Carvajal, Cristóbal</creatorcontrib><creatorcontrib>Torres, María Fernanda</creatorcontrib><creatorcontrib>Cruces, Pablo</creatorcontrib><collection>ScienceDirect Open Access Titles</collection><collection>Elsevier:ScienceDirect:Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>SciELO</collection><jtitle>Revista Chilena de pediatría</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Erranz, Benjamín</au><au>Díaz, Franco</au><au>Donoso, Alejandro</au><au>Salomón, Tatiana</au><au>Carvajal, Cristóbal</au><au>Torres, María Fernanda</au><au>Cruces, Pablo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Decreased lung compliance increases preload dynamic tests in a pediatric acute lung injury model</atitle><jtitle>Revista Chilena de pediatría</jtitle><addtitle>Rev Chil Pediatr</addtitle><date>2015-11-01</date><risdate>2015</risdate><volume>86</volume><issue>6</issue><spage>404</spage><epage>409</epage><pages>404-409</pages><issn>0370-4106</issn><eissn>0717-6228</eissn><abstract>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.
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.
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).
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.
Test dinámicos de precarga, variación de presión de pulso (PPV) y variación de volumen sistólico (SVV) han emergido como herramientas poderosas para predecir respuesta a la administración de fluidos. Actualmente la influencia de factores distintos a la precarga en la determinación de los test dinámicos de precarga es pobremente conocida en pediatría. Nuestro objetivo fue medir el efecto del volumen tidal (VT) sobre PPV y SVV en un contexto de compliance pulmonar normal y disminuida en un modelo porcino.
Veinte cerditos Large-White anestesiados y paralizados (5,2±0,4kg). PPV y SVV fueron medidos por análisis de contorno de pulso durante ventilación con VT de 6 y 12mL/kg (VT bajo y alto, respectivamente), ambos previo y posterior a lesión pulmonar aguda (ALI) químicamente inducida con instilación traqueal de polisorbato 20.
Previo a inducción de ALI, PPV y SVV no tuvieron cambios significativos al modificar el VT. Sin embargo, después de ALI, PPV y SVV fueron significativamente mayores durante ventilación con VT alto, respecto a VT bajo (PPV aumentó de 8,9±1,2 a 12,4±1,1%, y SVV de 8,5±1,0 a 12,7±1,2%, ambos P<0,01).
Este estudio encontró que un VT alto y una compliance pulmonar disminuida debido a ALI incrementan los test dinámicos de precarga, con una mayor influencia de esta última. En sujetos con ALI la compliance pulmonar debiera ser considerada al interpretar los test dinámicos de precarga.</abstract><cop>Chile</cop><pub>Elsevier España, S.L.U</pub><pmid>26471316</pmid><doi>10.1016/j.rchipe.2015.06.023</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| ispartof | Revista Chilena de pediatría, 2015-11, Vol.86 (6), p.404-409 |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; Alma/SFX Local Collection |
| subjects | Acute lung injury Acute Lung Injury - physiopathology Animals Blood Pressure - physiology Disease Models, Animal Fluid Therapy - methods Hemodinamia Hemodynamics Lesión Pulmonar Aguda Lung Compliance - physiology Mechanical ventilation Pediatric PEDIATRICS Pediatría Precarga Preload Respiration, Artificial - methods Stroke Volume - physiology Swine Tidal Volume - physiology Ventilación Mecánica |
| title | Decreased lung compliance increases preload dynamic tests in a pediatric acute lung injury model |
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