Systolic arterial pressure variability reflects circulating blood volume alterations in hemorrhagic shock in rabbits.

Shock

Division of Clinical Medical Science, Department of Anesthesiology and Critical Care, Graduate School of Biomedical Sciences, Hiroshima University, 1-2-3 Kasumi, Minami-ku, Hiroshima, Japan.

Published: December 2007

Both the high-frequency component of systolic arterial pressure variability and systolic pressure variation (SPV) have been indicated to be strongly affected by respiratory effect and sensitively reflect circulating blood volume (CBV). We attempted to determine the best means reflecting CBV from various parameters using power spectrum analyses of systolic arterial pressure variability (PSSAPV) and heart rate variability (PSHRV), SPV, and pulse pressure variation during graded hemorrhaging and fluid resuscitation. Under isoflurane anesthesia and mechanical ventilation, rabbits in group S (n = 6) had hemorrhaging induced, whereas those in group H (n = 10) had hemorrhaging induced followed by fluid resuscitation. After collecting baseline data, blood was withdrawn at a rate of 1 mL.kg.min for 25 min in both groups, and data were collected at 5 min after bleeding was stopped. Furthermore, in group H, hydroxyethyl starch was continuously infused at a rate of 1 mL.kg.min for 25 min; data were collected at 5 and 60 min after fluid resuscitation. The correlations between CBV and total power (TP, 0.04-2.00 Hz), high-frequency component (0.75-1.40 Hz), and low-frequency component (0.04-0.40 Hz) of PSSAPV were more significant as compared with SPV and pulse pressure variation, whereas no correlations were noted between CBV and PSHRV. To evaluate the regression models appropriately, Akaike information criterion was used, and TP of PSSAPV showed the lowest value. We concluded that TP of PSSAPV most sensitively reflected changes of CBV and that PSSAPV was the most useful parameter for evaluation of volume status as compared with conventional circulatory parameters.

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http://dx.doi.org/10.1097/shk.0b013e318054dfe3DOI Listing

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