help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by MICHARD, F.
Right arrow Articles by TEBOUL, J.-L.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by MICHARD, F.
Right arrow Articles by TEBOUL, J.-L.

Am. J. Respir. Crit. Care Med., Volume 162, Number 1, July 2000, 134-138

Relation between Respiratory Changes in Arterial Pulse Pressure and Fluid Responsiveness in Septic Patients with Acute Circulatory Failure

FRÉDÉRIC MICHARD, SANDRINE BOUSSAT, DENIS CHEMLA, NADIA ANGUEL, ALAIN MERCAT, YVES LECARPENTIER, CHRISTIAN RICHARD, MICHAEL R. PINSKY, and JEAN-LOUIS TEBOUL

Service de Réanimation Médicale et Service de Physiologie Cardio-Respiratoire, Centre Hospitalo-Universitaire de Bicêtre, Assistance Publique-Hopitaux de Paris, Le Kremlin Bicêtre, Université Paris XI, Paris, France; INSERM U451-LOA-ENSTA-Ecole Polytechnique, Palaiseau, France; and Division of Critical Care Medicine, University of Pittsburgh, Pittsburgh, Pennsylvania

In mechanically ventilated patients with acute circulatory failure related to sepsis, we investigated whether the respiratory changes in arterial pressure could be related to the effects of volume expansion (VE) on cardiac index (CI). Forty patients instrumented with indwelling systemic and pulmonary artery catheters were studied before and after VE. Maximal and minimal values of pulse pressure (Ppmax and Ppmin) and systolic pressure (Psmax and Psmin) were determined over one respiratory cycle. The respiratory changes in pulse pressure (Delta Pp) were calculated as the difference between Ppmax and Ppmin divided by the mean of the two values and were expressed as a percentage. The respiratory changes in systolic pressure (Delta Ps) were calculated using a similar formula. The VE-induced increase in CI was >=  15% in 16 patients (responders) and < 15% in 24 patients (nonresponders). Before VE, Delta Pp (24 ± 9 versus 7 ± 3%, p < 0.001) and Delta Ps (15 ± 5 versus 6 ± 3%, p < 0.001) were higher in responders than in nonresponders. Receiver operating characteristic (ROC) curves analysis showed that Delta Pp was a more accurate indicator of fluid responsiveness than Delta Ps. Before VE, a Delta Pp value of 13% allowed discrimination between responders and nonresponders with a sensitivity of 94% and a specificity of 96%. VE-induced changes in CI closely correlated with Delta Pp before volume expansion (r2 = 0.85, p < 0.001). VE decreased Delta Pp from 14 ± 10 to 7 ± 5% (p < 0.001) and VE-induced changes in Delta Pp correlated with VE-induced changes in CI (r2 = 0.72, p < 0.001). It was concluded that in mechanically ventilated patients with acute circulatory failure related to sepsis, analysis of Delta Pp is a simple method for predicting and assessing the hemodynamic effects of VE, and that Delta Pp is a more reliable indicator of fluid responsiveness than Delta Ps.




This article has been cited by other articles:


Home page
 Anesth. Analg.Home page
G. Pestel, K. Fukui, V. Hartwich, P. M. Schumacher, A. Vogt, L. B. Hiltebrand, A. Kurz, Y. Fujita, D. Inderbitzin, and D. Leibundgut
Automatic Algorithm for Monitoring Systolic Pressure Variation and Difference in Pulse Pressure
Anesth. Analg., June 1, 2009; 108(6): 1823 - 1829.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
D. J. Funk, E. W. Moretti, and T. J. Gan
Minimally Invasive Cardiac Output Monitoring in the Perioperative Setting
Anesth. Analg., March 1, 2009; 108(3): 887 - 897.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. Cannesson, H. Musard, O. Desebbe, C. Boucau, R. Simon, R. Henaine, and J.-J. Lehot
The Ability of Stroke Volume Variations Obtained with Vigileo/FloTrac System to Monitor Fluid Responsiveness in Mechanically Ventilated Patients
Anesth. Analg., February 1, 2009; 108(2): 513 - 517.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
M. Biais, K. Nouette-Gaulain, V. Cottenceau, P. Revel, and F. Sztark
Uncalibrated pulse contour-derived stroke volume variation predicts fluid responsiveness in mechanically ventilated patients undergoing liver transplantation
Br. J. Anaesth., December 1, 2008; 101(6): 761 - 768.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
M. Cannesson, O. Desebbe, P. Rosamel, B. Delannoy, J. Robin, O. Bastien, and J.-J. Lehot
Pleth variability index to monitor the respiratory variations in the pulse oximeter plethysmographic waveform amplitude and predict fluid responsiveness in the operating theatre
Br. J. Anaesth., August 1, 2008; 101(2): 200 - 206.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
L. Muller, G. Louart, C. Bengler, P. Fabbro-Peray, J. Carr, J. Ripart, J.-E. de La Coussaye, and J.-Y. Lefrant
The Intrathoracic Blood Volume Index as an Indicator of Fluid Responsiveness in Critically Ill Patients with Acute Circulatory Failure: A Comparison with Central Venous Pressure
Anesth. Analg., August 1, 2008; 107(2): 607 - 613.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
P. E. Marik, M. Baram, and B. Vahid
Does Central Venous Pressure Predict Fluid Responsiveness?: A Systematic Review of the Literature and the Tale of Seven Mares
Chest, July 1, 2008; 134(1): 172 - 178.
[Abstract] [Full Text] [PDF]

Home page
 J Intensive Care MedHome page
J.-L. Canivet, P. Lancellotti, M. Radermecker, and P. Damas
Cyclic Appearance of Left Ventricular Outflow Tract Dynamic Obstruction During Mechanical Ventilation: Evidence for a Preload Dependent Phenomenon
J Intensive Care Med, July 1, 2008; 23(4): 281 - 284.
[Abstract] [PDF]

Home page
 Br J AnaesthHome page
A. Miller, N. Coleman, A. Morelli, C. Ertmer, and M. Westphal
Dobutamine and terlipressin in patients with septic shock
Br. J. Anaesth., July 1, 2008; 101(1): 125 - 126.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
A. Perel
Automated Assessment of Fluid Responsiveness in Mechanically Ventilated Patients
Anesth. Analg., April 1, 2008; 106(4): 1031 - 1033.
[Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. Cannesson, B. Delannoy, A. Morand, P. Rosamel, Y. Attof, O. Bastien, and J.-J. Lehot
Does the Pleth Variability Index Indicate the Respiratory-Induced Variation in the Plethysmogram and Arterial Pressure Waveforms?
Anesth. Analg., April 1, 2008; 106(4): 1189 - 1194.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. Cannesson, J. Slieker, O. Desebbe, C. Bauer, P. Chiari, R. Henaine, and J.-J. Lehot
The Ability of a Novel Algorithm for Automatic Estimation of the Respiratory Variations in Arterial Pulse Pressure to Monitor Fluid Responsiveness in the Operating Room
Anesth. Analg., April 1, 2008; 106(4): 1195 - 1200.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
J. O. Auler Jr., F. Galas, L. Hajjar, L. Santos, T. Carvalho, and F. Michard
Online Monitoring of Pulse Pressure Variation to Guide Fluid Therapy After Cardiac Surgery
Anesth. Analg., April 1, 2008; 106(4): 1201 - 1206.
[Abstract] [Full Text] [PDF]

Home page
 CJASNHome page
D. Davison and C. Junker
Advances in Critical Care for the Nephrologist: Hemodynamic Monitoring and Volume Management
Clin. J. Am. Soc. Nephrol., March 1, 2008; 3(2): 554 - 561.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
E. Deflandre, V. Bonhomme, and P. Hans
Delta down compared with delta pulse pressure as an indicator of volaemia during intracranial surgery
Br. J. Anaesth., February 1, 2008; 100(2): 245 - 250.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
L. Durairaj and G. A. Schmidt
Fluid Therapy in Resuscitated Sepsis: Less Is More
Chest, January 1, 2008; 133(1): 252 - 263.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. R. Pinsky
Hemodynamic Evaluation and Monitoring in the ICU
Chest, December 1, 2007; 132(6): 2020 - 2029.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
J-H. Lee, J-T. Kim, S. Z. Yoon, Y-J. Lim, Y. Jeon, J-H. Bahk, and C. S. Kim
Evaluation of corrected flow time in oesophageal Doppler as a predictor of fluid responsiveness
Br. J. Anaesth., September 1, 2007; 99(3): 343 - 348.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
G. Natalini
Variations in Photoplethysmographic Waveform During Mechanical Ventilation
Anesth. Analg., June 1, 2007; 104(6): 1599 - 1600.
[Full Text] [PDF]

Home page
 ChestHome page
J. M. Brennan, J. E. A. Blair, C. Hampole, S. Goonewardena, S. Vasaiwala, D. Shah, K. T. Spencer, and G. A. Schmidt
Radial Artery Pulse Pressure Variation Correlates With Brachial Artery Peak Velocity Variation in Ventilated Subjects When Measured by Internal Medicine Residents Using Hand-Carried Ultrasound Devices
Chest, May 1, 2007; 131(5): 1301 - 1307.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
C. Runcie, B. Tavernier, H. Solus-Biguenet, M. Fleyfel, and B. Vallet
Predicting fluid responsiveness in theatre
Br. J. Anaesth., April 1, 2007; 98(4): 545 - 547.
[Full Text] [PDF]

Home page
 J Intensive Care MedHome page
S. Magder and F. Bafaqeeh
The Clinical Role of Central Venous Pressure Measurements
J Intensive Care Med, January 1, 2007; 22(1): 44 - 51.
[Abstract] [PDF]

Home page
 Br J AnaesthHome page
A. Mekontso-Dessap, L. Tual, M. Kirsch, G. D'Honneur, D. Loisance, L. Brochard, and J.-L. Teboul
B-type natriuretic peptide to assess haemodynamic status after cardiac surgery
Br. J. Anaesth., December 1, 2006; 97(6): 777 - 782.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
G. Natalini, A. Rosano, M. Taranto, B. Faggian, E. Vittorielli, and A. Bernardini
Arterial Versus Plethysmographic Dynamic Indices to Test Responsiveness for Testing Fluid Administration in Hypotensive Patients: A Clinical Trial
Anesth. Analg., December 1, 2006; 103(6): 1478 - 1484.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
G. Natalini, A. Rosano, M. E. Franceschetti, P. Facchetti, and A. Bernardini
Variations in Arterial Blood Pressure and Photoplethysmography During Mechanical Ventilation
Anesth. Analg., November 1, 2006; 103(5): 1182 - 1188.
[Abstract] [Full Text] [PDF]

Home page
 Eur Respir JHome page
L. Watson, J. P. Schouten, C-G. Lofdahl, N. B. Pride, L. A. Laitinen, D. S. Postma, and on behalf of the European Respiratory Society Stud
Predictors of COPD symptoms: does the sex of the patient matter?
Eur. Respir. J., August 1, 2006; 28(2): 311 - 318.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. B. Borges, V. N. Okamoto, G. F. J. Matos, M. P. R. Caramez, P. R. Arantes, F. Barros, C. E. Souza, J. A. Victorino, R. M. Kacmarek, C. S. V. Barbas, et al.
Reversibility of Lung Collapse and Hypoxemia in Early Acute Respiratory Distress Syndrome
Am. J. Respir. Crit. Care Med., August 1, 2006; 174(3): 268 - 278.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
C. Charron, C. Fessenmeyer, C. Cosson, J.-X. Mazoit, J.-L. Hebert, D. Benhamou, and A. R. Edouard
The Influence of Tidal Volume on the Dynamic Variables of Fluid Responsiveness in Critically Ill Patients.
Anesth. Analg., May 1, 2006; 102(5): 1511 - 1517.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
S. Preisman, S. Kogan, H. Berkenstadt, and A. Perel
Predicting fluid responsiveness in patients undergoing cardiac surgery: functional haemodynamic parameters including the Respiratory Systolic Variation Test and static preload indicators
Br. J. Anaesth., December 1, 2005; 95(6): 746 - 755.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
R. J. Wright
Make No Bones About It: Increasing Epidemiologic Evidence Links Vitamin D to Pulmonary Function and COPD
Chest, December 1, 2005; 128(6): 3781 - 3783.
[Full Text] [PDF]

Home page
 ChestHome page
F. Michard
Volume Management Using Dynamic Parameters
Chest, October 1, 2005; 128(4): 1902 - 1903.
[Full Text] [PDF]

Home page
 ChestHome page
C. K. Hofer, S. M. Muller, L. Furrer, R. Klaghofer, M. Genoni, and A. Zollinger
Stroke Volume and Pulse Pressure Variation for Prediction of Fluid Responsiveness in Patients Undergoing Off-Pump Coronary Artery Bypass Grafting
Chest, August 1, 2005; 128(2): 848 - 854.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
Y. Beaulieu and P. E. Marik
Bedside Ultrasonography in the ICU: Part 1
Chest, August 1, 2005; 128(2): 881 - 895.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
H. Berkenstadt, Z. Friedman, S. Preisman, I. Keidan, D. Livingstone, and A. Perel
Pulse pressure and stroke volume variations during severe haemorrhage in ventilated dogs
Br. J. Anaesth., June 1, 2005; 94(6): 721 - 726.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. P. W. Grocott, M. G. Mythen, and T. J. Gan
Perioperative Fluid Management and Clinical Outcomes in Adults
Anesth. Analg., April 1, 2005; 100(4): 1093 - 1106.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
D. A. Reuter, M. S. G. Goepfert, T. Goresch, M. Schmoeckel, E. Kilger, and A. E. Goetz
Assessing fluid responsiveness during open chest conditions
Br. J. Anaesth., March 1, 2005; 94(3): 318 - 323.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
S. Rex, S. Brose, S. Metzelder, R. Huneke, G. Schalte, R. Autschbach, R. Rossaint, and W. Buhre
Prediction of fluid responsiveness in patients during cardiac surgery
Br. J. Anaesth., December 1, 2004; 93(6): 782 - 788.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
A. Kramer, D. Zygun, H. Hawes, P. Easton, and A. Ferland
Pulse Pressure Variation Predicts Fluid Responsiveness Following Coronary Artery Bypass Surgery
Chest, November 1, 2004; 126(5): 1563 - 1568.
[Abstract] [Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
F. Michard, U. Schmidt, K. Bendjelid, and J.-A. Romand
Prediction of fluid responsiveness: searching for the Holy Grail
J Appl Physiol, August 1, 2004; 97(2): 790 - 791.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
F. Michard, D. Chemla, J.-L. Teboul, and S. Magder
More Respect for Respiratory Variation in Arterial Pressure
Am. J. Respir. Crit. Care Med., June 15, 2004; 169(12): 1333 - 1334.
[Full Text] [PDF]

Home page
 Br J AnaesthHome page
D. A. Reuter, T. Goresch, M. S. G. Goepfert, S. M. Wildhirt, E. Kilger, and A. E. Goetz
Effects of mid-line thoracotomy on the interaction between mechanical ventilation and cardiac filling during cardiac surgery
Br. J. Anaesth., June 1, 2004; 92(6): 808 - 813.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
S. Magder
Clinical Usefulness of Respiratory Variations in Arterial Pressure
Am. J. Respir. Crit. Care Med., January 15, 2004; 169(2): 151 - 155.
[Full Text] [PDF]

Home page
 J. Appl. Physiol.Home page
K. Bendjelid, P. M. Suter, and J. A. Romand
The respiratory change in preejection period: a new method to predict fluid responsiveness
J Appl Physiol, January 1, 2004; 96(1): 337 - 342.
[Abstract] [Full Text] [PDF]

Home page
 Br J AnaesthHome page
J. J. Tenhunen, T. J. Martikainen, A. Uusaro, and E. Ruokonen
Dopexamine reverses colonic but not gastric mucosal perfusion defects in lethal endotoxin shock
Br. J. Anaesth., December 1, 2003; 91(6): 878 - 885.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. Vieillard-Baron, S. Prin, K. Chergui, O. Dubourg, and F. Jardin
Hemodynamic Instability in Sepsis: Bedside Assessment by Doppler Echocardiography
Am. J. Respir. Crit. Care Med., December 1, 2003; 168(11): 1270 - 1276.
[Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
A. Vieillard-Baron, K. Chergui, R. Augarde, S. Prin, B. Page, A. Beauchet, and F. Jardin
Cyclic Changes in Arterial Pulse during Respiratory Support Revisited by Doppler Echocardiography
Am. J. Respir. Crit. Care Med., September 15, 2003; 168(6): 671 - 676.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
C. Morelot-Panzini, Y. Lefort, J.-P. Derenne, and T. Similowski
Simplified Method to Measure Respiratory-Related Changes in Arterial Pulse Pressure in Patients Receiving Mechanical Ventilation
Chest, August 1, 2003; 124(2): 665 - 670.
[Abstract] [Full Text] [PDF]

Home page
 Anesth. Analg.Home page
M. R. Pinsky
Probing the Limits of Arterial Pulse Contour Analysis to Predict Preload Responsiveness
Anesth. Analg., May 1, 2003; 96(5): 1245 - 1247.
[Full Text] [PDF]

Home page
 Arch. Dis. Child.Home page
S M Tibby and I A Murdoch
Monitoring cardiac function in intensive care
Arch. Dis. Child., January 1, 2003; 88(1): 46 - 52.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Physiol. Heart Circ. Physiol.Home page
M. Slama, H. Masson, J.-L. Teboul, M.-L. Arnout, D. Susic, E. Frohlich, and M. Andrejak
Respiratory variations of aortic VTI: a new index of hypovolemia and fluid responsiveness
Am J Physiol Heart Circ Physiol, October 1, 2002; 283(4): H1729 - H1733.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
F. Michard and J.-L. Teboul
Predicting Fluid Responsiveness in ICU Patients* : A Critical Analysis of the Evidence
Chest, June 1, 2002; 121(6): 2000 - 2008.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
T. Boulain, J.-M. Achard, J.-L. Teboul, C. Richard, D. Perrotin, and G. Ginies
Changes in BP Induced by Passive Leg Raising Predict Response to Fluid Loading in Critically Ill Patients*
Chest, April 1, 2002; 121(4): 1245 - 1252.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
M. J. TOBIN
Critical Care Medicine in AJRCCM 2000
Am. J. Respir. Crit. Care Med., October 15, 2001; 164(8): 1347 - 1361.
[Full Text] [PDF]

Home page
 ChestHome page
M. Feissel, F. Michard, I. Mangin, O. Ruyer, J.-P. Faller, and J.-L. Teboul
espiratory Changes in Aortic Blood Velocity as an Indicator of Fluid Responsiveness in Ventilated Patients With Septic Shock
Chest, March 1, 2001; 119(3): 867 - 873.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 2000 American Thoracic Society 		  Tobacco