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oa Southern African Journal of Anaesthesia and Analgesia - The effect of positive end-expiratory pressure on pulse pressure variation : original research

 

Abstract

To determine the effect of different levels of positive end-expiratory pressure (PEEP) on pulse pressure variation (PPV).


An observational study.
Operating theatres of a tertiary training hospital.
Ventilated patients who required intra-arterial blood pressure monitoring.
PPV during different levels of PEEP.
Patients were anaesthetised by means of a standard technique and ventilated with a tidal volume of 9 ml/kg ideal body mass. The PPV was calculated at PEEP levels of 2, 5, 8 and 10 cmHO. PPV was compared at the various PEEP levels.
PPV at a PEEP of 8 cmHO and 10 cmHO was significantly larger than that at 2 cmHO (p-value < 0.001). PPV at a PEEP of 10 cmHO was significantly larger than that at 8 cmHO (p-value < 0.001). PPV at a PEEP of 8 cmHO was larger than that at 5 cmHO (p-value = 0.002). PPV at a PEEP of 2 and 5 cmHO did not differ significantly (p-value = 0.194).
We have demonstrated that, in patients with normal lungs, PEEP has a significant influence on PPV. PPV may be overestimated if PEEP ≥ 8 cmHO is applied in patients who are ventilated with a tidal volume of 9 ml/kg. It is recommended that in patients with healthy lungs PPV should be measured at a standardised PEEP of ≤ 5 cmHO.

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/content/medsajaa/18/6/EJC129040
2012-11-01
2016-12-04
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