Hemodynamic Parameters Change Earlier Than Tissue Oxygen Tension in Hemorrhage
BACKGROUND: Untreated hypovolemia results in impaired outcome. This study tests our hypothesis whether general hemodynamic parameters detect acute blood loss earlier than monitoring parameters of regional tissue beds. MATERIALS AND METHODS: Eight pigs (23-25 kg) were anesthetized and mechanically ventilated. A pulmonary artery catheter and an arterial catheter were inserted. Tissue oxygen tension was measured with Clark-type electrodes in the jejunal and colonic wall, in the liver, and subcutaneously. Jejunal microcirculation was assessed by laser Doppler flowmetry (LDF). Intravascular volume was optimized using difference in pulse pressure (dPP) to keep dPP below 13%. Sixty minutes after p…
Effect of Supplemental Oxygen versus Dobutamine Administration on Liver Oxygen Tension in dPP-Guided Normovolemic Pigs
<i>Background:</i> Difference in pulse pressure (dPP) confirms adequate intravascular filling as a prerequisite for tissue perfusion. We hypothesized that both oxygen and dobutamine increase liver tissue oxygen tension (pt<i>O</i><sub>2</sub>). <i>Methods:</i> Eight anesthetized pigs received dPP-guided fluid management. Hepatic p<i>O</i><sub>2</sub> was measured with Clark-type electrodes placed subcapsularly, and on the liver surface. Pigs received: (1) supplemental oxygen (F<sub>i</sub><i>O</i><sub>2</sub> 1.0); (2) dobutamine 2.5 μg/kg/min, and (3) dobutamine 5 μg/kg/min. Data wer…
Automatic algorithm for monitoring systolic pressure variation and difference in pulse pressure.
BACKGROUND: Difference in pulse pressure (dPP) reliably predicts fluid responsiveness in patients. We have developed a respiratory variation (RV) monitoring device (RV monitor), which continuously records both airway pressure and arterial blood pressure (ABP). We compared the RV monitor measurements with manual dPP measurements. METHODS: ABP and airway pressure (PAW) from 24 patients were recorded. Data were fed to the RV monitor to calculate dPP and systolic pressure variation in two different ways: (a) considering both ABP and PAW (RV algorithm) and (b) ABP only (RV(slim) algorithm). Additionally, ABP and PAW were recorded intraoperatively in 10-min intervals for later calculation of dPP …