End-expiratory occlusion test (EEOT) has been proposed as a preload responsiveness test that overcomes several limitations of pulse pressure (PPV) and stroke volume (SVV) variations. We compared the ability of EEOT versus SVV and PPV to predict fluid responsiveness during the increase of the vasomotor tone in a rabbit model of hemorrhage. Ten rabbits were anesthetized, paralyzed, and mechanically ventilated during basal load (BL), after progressive blood withdrawal (BW), and after volume replacement. Other two sets of data were obtained during vasomotor increase by phenylephrine (PHE) infusion in BL and BW. We estimated the change of stroke volume (∆SVEEOT) and aortic flow (∆AoFEEOT) during the EEOT. PPV and SVV were obtained by the variation of beat-to-beat PP and SV, respectively. Baseline PPV, SVV, ∆SVEEOT, and ∆AoFEEOT increased significantly after BW, with a decrease of aortic flow (P < 0.05). PHE induced a significant decrease of PPV and SVV, but without affecting ∆SVEEOT, and ∆AoFEEOT. We conclude that ∆SV and ∆AoF during EEOT kept the ability to predict fluid responsiveness during PHE infusion in a rabbit hemorrhage model. This result may suggest the advantage of EEOT with respect to SVV and PPV in predicting fluid responsiveness during vasomotor tone increase.

译文

呼气末阻塞测试 (EEOT) 已被提议作为一种预载响应性测试,克服了脉压 (PPV) 和中风量 (SVV) 变化的几个限制。我们比较了EEOT与SVV和PPV在兔出血模型中血管舒缩张力增加期间预测液体反应性的能力。在基础负荷 (BL),进行性抽血 (BW) 和容量置换后,将十只兔子麻醉,瘫痪和机械通气。在BL和BW中输注去氧肾上腺素 (PHE) 增加血管舒缩期间获得了其他两组数据。我们估计了EEOT期间中风量 (∆ sveeot) 和主动脉血流 (∆ aofeeot) 的变化。PPV和SVV分别通过节拍PP和SV的变化获得。基线PPV、SVV、 ∆ sveeot和 ∆ aofeeot在BW后显著增加,主动脉血流减少 (p  <  0.05)。PHE引起PPV和SVV的显着降低,但不影响 ∆ sveeot和 ∆ aofeeot。我们得出的结论是,EEOT期间的 ∆ sv和 ∆ aof在兔出血模型中保持了预测PHE输注期间液体反应性的能力。该结果可能表明EEOT相对于SVV和PPV在预测血管舒缩张力增加期间的液体反应性方面具有优势。

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