STUDY OBJECTIVE: To investigate changes in stroke volume variation (SVV) by both induced hypertension (pressor test) and hypotension (depressor test), and also by induced hypotensive anesthesia in patients with good cardiac function. DESIGN: Prospective, controlled clinical study. SETTING: University hospital. PATIENTS: 31 ASA physical status 1 and 2 patients, aged 39-62 years, who were scheduled for elective surgery. INTERVENTIONS: We conducted three studies: a pressor test study, a depressor test study, and an induced hypotensive anesthesia study. In the pressor test, patients received a bolus of phenylephrine 0.001 mg/kg to increase systolic arterial pressure (SAP) by 30% to 40% compared with baseline. In the depressor test, patients received a bolus of nitroglycerine 0.005 mg/kg to decrease SAP by 30% to 40% compared with baseline. In the induced hypotensive anesthesia test, patients received intravenous (IV) nitroglycerine continuously until mean arterial pressure (MAP) was reduced to 60-70 mmHg. MEASUREMENTS: When arterial pressure reached the target pressure for each study type, SVV and other parameters were recorded. MAIN RESULTS: Induced hypertension (pressor test) decreased SVV, while induced hypotension (depressor test) and induced hypotensive anesthesia increased SVV. CONCLUSIONS: SVV does not misinterpret preload dependency assessment of patients receiving medications to increase or to lower blood pressure.
STUDY OBJECTIVE: To investigate changes in stroke volume variation (SVV) by both induced hypertension (pressor test) and hypotension (depressor test), and also by induced hypotensive anesthesia in patients with good cardiac function. DESIGN: Prospective, controlled clinical study. SETTING: University hospital. PATIENTS: 31 ASA physical status 1 and 2 patients, aged 39-62 years, who were scheduled for elective surgery. INTERVENTIONS: We conducted three studies: a pressor test study, a depressor test study, and an induced hypotensive anesthesia study. In the pressor test, patients received a bolus of phenylephrine 0.001 mg/kg to increase systolic arterial pressure (SAP) by 30% to 40% compared with baseline. In the depressor test, patients received a bolus of nitroglycerine 0.005 mg/kg to decrease SAP by 30% to 40% compared with baseline. In the induced hypotensive anesthesia test, patients received intravenous (IV) nitroglycerine continuously until mean arterial pressure (MAP) was reduced to 60-70 mmHg. MEASUREMENTS: When arterial pressure reached the target pressure for each study type, SVV and other parameters were recorded. MAIN RESULTS: Induced hypertension (pressor test) decreased SVV, while induced hypotension (depressor test) and induced hypotensive anesthesia increased SVV. CONCLUSIONS: SVV does not misinterpret preload dependency assessment of patients receiving medications to increase or to lower blood pressure.
Authors: Alexandre Hideaki Oshiro; Denise Aya Otsuki; Marcelo Waldir M Hamaji; Kaleizu T Rosa; Keila Kazue Ida; Denise T Fantoni; José Otavio Costa Auler Journal: Clinics (Sao Paulo) Date: 2015-12 Impact factor: 2.365