The effects of respiratory rate and tidal volume on pulse pressure variation in healthy lungs–a generalized additive model approach may help overcome limitations

• DOI: 10.1007/s10877-023-01090-6
• Publication Date: 2023-11-16T03:01:27Z
• Authors: Johannes Enevoldsen; Birgitte Brandsborg; Peter Juhl-Olsen; Stephen Edward Rees; Henriette Vind Th...; Thomas W. L. Sche...; Simon Tilma Vistisen
• Keywords: Pulse pressure; Respiratory Rate

Abstract Pulse pressure variation (PPV) is a well-established method for predicting fluid responsiveness in mechanically ventilated patients. The predictive accuracy is, however, disputed ventilation with low tidal volume (V T ) or heart-rate-to-respiratory-rate ratio (HR/RR). We investigated the effects of V and RR on PPV PPV’s ability to predict responsiveness. included patients scheduled open abdominal surgery. Prior 250 ml bolus, we combinations from 4 10 kg −1 31 min . For each RR-V combinations, was derived using both classic approach generalized additive model (GAM) approach. stroke (SV) response evaluated uncalibrated pulse contour analysis. An SV increase > 10% defined Fifty 52 received bolus. Ten were responders. all ventilator settings, prediction inconclusive point estimates area under receiver operating characteristics curve between 0.62 0.82. Both measures nearly proportional Higher associated lower PPV. Classically affected more by than GAM-derived Correcting could improve utility. Low HR/RR has limited effect PPV, indicating that limitation related how calculated. did not demonstrate any benefit Trial registration: ClinicalTrials.gov, reg. March 6, 2020, NCT04298931.