The clinical relevance of systolic pressure variations in anesthetized nonhypotensive patients

Abstract

Objective: To assess the accuracy of respiratory-induced systolic pressure variation and its components to detect low left ventricular preload.

Design: Prospective study.

Setting: University hospital.

Participants: Sixty-seven patients undergoing major surgery under general anesthesia.

Interventions: Transesophageal echocardiographic measurements during apnea and mechanical ventilation.

Measurements and main results: Respiratory-induced systolic pressure variation and its components and left ventricular end-diastolic area obtained by transesophageal echocardiography were noted simultaneously. Arterial pressure indices did not allow a reliable diagnosis of a low left ventricular end-diastolic area using a cut-off value of 7.9 cm(2)/m(2) (inferior boundary of the interquartile range of the areas measured in the authors' group).

Conclusions: These results suggest that systolic pressure variations noticed after induction of general anesthesia do not reflect low left ventricular preload in nonhypotensive patients.