Pulse pressure variation and stroke volume variation under different inhaled concentrations of isoflurane, sevoflurane and desflurane in pigs undergoing hemorrhage.
Pulse pressure variation and stroke volume variation under different inhaled concentrations of isoflurane, sevoflurane and desflurane in pigs undergoing hemorrhage.
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DOI：
10.6061/clinics/2015(12)07
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发表时间：
2015-12
期刊：
影响因子：
--
通讯作者：
Auler JO Jr
中科院分区：
文献类型：
--
作者：
Oshiro AH;Otsuki DA;Hamaji MW;Rosa KT;Ida KK;Fantoni DT;Auler JO Jr
吸入麻醉诱导剂量依赖性心血管抑制，但液体反应性是否受到吸入剂和血浆容量的不同影响仍不清楚。本研究旨在比较异氟烷、七氟烷和地氟烷对出血猪的脉压变异性和每搏输出量变异性的影响。25只猪随机用异氟烷、七氟烷或地氟烷麻醉。在最小肺泡浓度为1.00（M1）、1.25（M2）和1.00（M3）时，依次记录血流动力学和超声心动图数据。然后，在抽取30%的估计血容量后，在1.00（M4）和1.25（M5）的最小肺泡浓度下记录这些数据。最小肺泡浓度从1.00增加到1.25（M2）降低了心脏指数并增加了中心静脉压，但从M1到M2，在所有组中仅观察到平均动脉压、脉压变异和每搏输出量变异的适度变化。仅在地氟烷时观察到平均动脉压显著降低。失血后（M4），所有组的脉压变异度、每搏输出量变异度和中心静脉压均增加（p<0.001），平均动脉压降低。在低血容量状态下，各组心脏指数随麻醉深度的增加而降低，其变化趋势相似。地氟醚、七氟醚和异氟醚对正常血容量和低血容量时脉压变异度和每搏输出量变异度的影响无差异。
Inhalant anesthesia induces dose-dependent cardiovascular depression, but whether fluid responsiveness is differentially influenced by the inhalant agent and plasma volemia remains unknown. The aim of this study was to compare the effects of isoflurane, sevoflurane and desflurane on pulse pressure variation and stroke volume variation in pigs undergoing hemorrhage. Twenty-five pigs were randomly anesthetized with isoflurane, sevoflurane or desflurane. Hemodynamic and echocardiographic data were registered sequentially at minimum alveolar concentrations of 1.00 (M1), 1.25 (M2), and 1.00 (M3). Then, following withdrawal of 30% of the estimated blood volume, these data were registered at a minimum alveolar concentrations of 1.00 (M4) and 1.25 (M5). The minimum alveolar concentration increase from 1.00 to 1.25 (M2) decreased the cardiac index and increased the central venous pressure, but only modest changes in mean arterial pressure, pulse pressure variation and stroke volume variation were observed in all groups from M1 to M2. A significant decrease in mean arterial pressure was only observed with desflurane. Following blood loss (M4), pulse pressure variation, stroke volume variation and central venous pressure increased (p<0.001) and mean arterial pressure decreased in all groups. Under hypovolemia, the cardiac index decreased with the increase of anesthesia depth in a similar manner in all groups. The effects of desflurane, sevoflurane and isoflurane on pulse pressure variation and stroke volume variation were not different during normovolemia or hypovolemia.