Comparison between respiratory pulse oximetry plethysmographic waveform amplitude and arterial pulse pressure variations among patients with and without norepinephrine use.

نویسندگان

  • Guilherme Loures de Araújo Penna
  • Paula Araujo Rosa
  • Pedro Martins Pereira Kurtz
  • Fabricio Braga
  • Gustavo Ferreira Almeida
  • Marcia Freitas
  • Luis Eduardo Drumond
  • Ronaldo Vegni E Souza
  • Michel Schatkin Cukier
  • André Salgado
  • Clóvis Faria
  • José Kezen
  • André Miguel Japiassú
  • Marcelo Kalichsztein
  • Gustavo Nobre
چکیده

OBJECTIVES Arterial pulse pressure respiratory variation is a good predictor of fluid response in ventilated patients. Recently, it was shown that respiratory variation in arterial pulse pressure correlates with variation in pulse oximetry plethysmographic waveform amplitude. We wanted to evaluate the correlation between respiratory variation in arterial pulse pressure and respiratory variation in pulse oximetry plethysmographic waveform amplitude, and to determine whether this correlation was influenced by norepinephrine administration. METHODS Prospective study of sixty patients with normal sinus rhythm on mechanical ventilation, profoundly sedated and with stable hemodynamics. Oxygenation index and invasive arterial pressure were monitored. Respiratory variation in arterial pulse pressure and respiratory variation in pulse oximetry plethysmographic waveform amplitude were recorded simultaneously in a beat-to-beat evaluation, and were compared using the Pearson coefficient of agreement and linear regression. RESULTS Thirty patients (50%) required norepinephrine. There was a significant correlation (K = 0.66; p < 0.001) between respiratory variation in arterial pulse pressure and respiratory variation in pulse oximetry plethysmographic waveform amplitude. Area under the ROC curve was 0.88 (range, 0.79 - 0.97), with a best cutoff value of 14% to predict a respiratory variation in arterial pulse pressure of 13. The use of norepinephrine did not influence the correlation (K = 0.63, p = 0.001, respectively). CONCLUSIONS Respiratory variation in arterial pulse pressure above 13% can be accurately predicted by a respiratory variation in pulse oximetry plethysmographic waveform amplitude of 14%. The use of norepinephrine does not alter this relationship.

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

منابع مشابه

Relation between respiratory variations in pulse oximetry plethysmographic waveform amplitude and arterial pulse pressure in ventilated patients

INTRODUCTION Respiratory variation in arterial pulse pressure is a reliable predictor of fluid responsiveness in mechanically ventilated patients with circulatory failure. The main limitation of this method is that it requires an invasive arterial catheter. Both arterial and pulse oximetry plethysmographic waveforms depend on stroke volume. We conducted a prospective study to evaluate the relat...

متن کامل

Arterial and plethysmographic waveform analysis in anesthetized patients with hypovolemia.

BACKGROUND Respiratory-induced arterial and plethysmographic (pulse oximetry) waveform changes were shown to be good predictors of cardiac output response to increased preload. The aim of this study was to evaluate the reliability of arterial and plethysmographic waveform variables in patients with mild hypovolemia. METHODS Patients undergoing autologous hemodilution were studied. After anest...

متن کامل

Respiratory Variation in Pulse Oximetry: A Simple Fluid Responsiveness Parameter

Respiratory variation in arterial pulse pressure (ΔPP) has been shown to be the most accurate predictor of fluid responsiveness in mechanically ventilated patients, with a predictive cutoff value of 13%. However, this dynamic parameter is invasive and not widely available. The pulse oximetry plethysmographic (POP) signal resembles the arterial pressure waveform in both shape and amplitude varia...

متن کامل

Pleth variability index to monitor the respiratory variations in the pulse oximeter plethysmographic waveform amplitude and predict fluid responsiveness in the operating theatre.

BACKGROUND Respiratory variations in pulse oximetry plethysmographic waveform amplitude (DeltaPOP) can predict fluid responsiveness in mechanically ventilated patients but cannot be easily assessed at the bedside. Pleth variability index (PVI) is a new algorithm allowing for automated and continuous monitoring of DeltaPOP. We hypothesized that PVI can predict fluid responsiveness in mechanicall...

متن کامل

Respiratory variations in pulse oximetry plethysmographic waveform amplitude to predict fluid responsiveness in the operating room.

BACKGROUND Respiratory variations in pulse oximetry plethysmographic waveform amplitude (DeltaPOP) are related to respiratory variations in pulse pressure (DeltaPP) and are sensitive to changes in preload. The authors hypothesized that DeltaPOP can predict fluid responsiveness in mechanically ventilated patients during general anesthesia. METHODS Twenty-five patients referred for cardiac surg...

متن کامل

ذخیره در منابع من


  با ذخیره ی این منبع در منابع من، دسترسی به آن را برای استفاده های بعدی آسان تر کنید

برای دانلود متن کامل این مقاله و بیش از 32 میلیون مقاله دیگر ابتدا ثبت نام کنید

ثبت نام

اگر عضو سایت هستید لطفا وارد حساب کاربری خود شوید

عنوان ژورنال:
  • Revista Brasileira de terapia intensiva

دوره 21 4  شماره 

صفحات  -

تاریخ انتشار 2009