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

:呼气末阻塞试验(EEOT)已被提出作为预负荷响应性试验,它克服了脉压(PPV)和搏动量(SVV)变化的若干限制。我们在兔出血模型中比较了EEOT与SVV和PPV预测在血管舒缩张力增加期间的液体反应性的能力。在基础负荷(BL),进行性采血(BW)和置换体积后,对10只兔子进行麻醉,瘫痪并进行机械通气。其他两组数据是在通过苯肾上腺素(PHE)注入BL和BW引起的血管舒缩过程中获得的。我们估算了EEOT期间的搏动量(∆SVEEOT)和主动脉血流(∆AoFEEOT)的变化。 PPV和SVV分别通过逐拍PP和SV的变化获得。 BW后基线PPV,SVV,∆SVEEOT和∆AoFEEOT显着增加,主动脉血流量减少(P <0.05)。 PHE导致PPV和SVV显着降低,但不影响∆SVEEOT和∆AoFEEOT。我们得出结论,在兔出血模型中,EEOT期间的∆SV和∆AoF保持了预测PHE输液期间液体反应性的能力。这一结果可能表明EEOT相对于SVV和PPV在预测血管舒张压增加期间的液体反应性方面的优势。

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