Pneumoperitoneum may induce important hemodynamic alterations in healthy subjects. Pulse pressure variation (PPV) is a hemodynamic parameter able to discriminate preload dependent subjects. Anesthesia records of dogs undergoing laparoscopy were retrospectively evaluated. The anesthetic protocol included acepromazine, methadone, propofol and isoflurane administered with oxygen under mechanical ventilation. The hemodynamic parameters were considered five minutes before (BASE) and ten minutes after (P10) the pneumoperitoneum. Based on the cardiac index (CI) variation, at P10, dogs were classified as sensitive (S group, CI ≤ 15%) and non-sensitive (NO-S group). Data were analyzed with the ANOVA test and the ROC curve (p < 0.05). Fifty-five percent of dogs (S) had a reduction of CI ≥ 15% at P10 (2.97 ± 1.4 L/min/m²) compared to BASE (4.32 ± 1.62 L/min/m²) and at P10 in the NO-S group (4.51 ± 1.41 L/min/m²). PPV at BASE was significantly higher in the S group (22.4% ± 6.1%) compared to the NO-S group (10.9% ± 3.3%). The ROC curve showed a threshold of PPV > 16% to distinguish the S and NO-S groups. PPV may be a valid predictor of the hemodynamic response to pneumoperitoneum in dogs. A PPV > 16% can identify patients that may require fluid administration before the creation of pneumoperitoneum.

Pulse Pressure Variation Can Predict the Hemodynamic Response to Pneumoperitoneum in Dogs: A Retrospective Study

Di Bella, Caterina;Lacitignola, Luca;Fracassi, Laura;Skouropoulou, Despoina;Crovace, Antonio;Staffieri, Francesco
2019

Abstract

Pneumoperitoneum may induce important hemodynamic alterations in healthy subjects. Pulse pressure variation (PPV) is a hemodynamic parameter able to discriminate preload dependent subjects. Anesthesia records of dogs undergoing laparoscopy were retrospectively evaluated. The anesthetic protocol included acepromazine, methadone, propofol and isoflurane administered with oxygen under mechanical ventilation. The hemodynamic parameters were considered five minutes before (BASE) and ten minutes after (P10) the pneumoperitoneum. Based on the cardiac index (CI) variation, at P10, dogs were classified as sensitive (S group, CI ≤ 15%) and non-sensitive (NO-S group). Data were analyzed with the ANOVA test and the ROC curve (p < 0.05). Fifty-five percent of dogs (S) had a reduction of CI ≥ 15% at P10 (2.97 ± 1.4 L/min/m²) compared to BASE (4.32 ± 1.62 L/min/m²) and at P10 in the NO-S group (4.51 ± 1.41 L/min/m²). PPV at BASE was significantly higher in the S group (22.4% ± 6.1%) compared to the NO-S group (10.9% ± 3.3%). The ROC curve showed a threshold of PPV > 16% to distinguish the S and NO-S groups. PPV may be a valid predictor of the hemodynamic response to pneumoperitoneum in dogs. A PPV > 16% can identify patients that may require fluid administration before the creation of pneumoperitoneum.
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Utilizza questo identificativo per citare o creare un link a questo documento: http://hdl.handle.net/11586/227237
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