This Article Résumé de cet Article Full Text Full Text (PDF) Submit a scholarly reply Alert me when this article is cited Alert me when eLetters are posted Alert me if a correction is posted Services Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Mallat, J. Articles by Tavernier, B. Search for Related Content PubMed PubMed Citation Articles by Mallat, J. Articles by Tavernier, B.

Systolic pressure variation (down) can guide fluid therapy during pheochromocytoma surgery

[La variation de la pression systolique (down) peut guider le remplissage vasculaire pendant la résection d’un phéochromocytome]

From the Federation of Anesthesia and Intensive Care, University Hospital, Lille, France.

Address correspondence to: Pr. Benoît Tavernier, Département d’anesthésie réanimation chirurgicale 1, Hôpital Roger Salengro, CHU de Lille, 59037 Lille cedex, France. Phone: 00 320 44 40 74; Fax: 00 320 44 49 07; E-mail: btavernier{at}chru-lille.fr

Purpose: To date, no monitoring has proved its usefulness for both interpretation and treatment of arterial hypotension following pheochromocytoma resection. In this prospective observational study, we measured the negative component (down) of the respiratory systolic pressure variation in order to assess its ability to guide fluid therapy in 13 patients undergoing pheochromocytoma surgery.

Methods: The arterial pressure waveform was recorded via a 20-g radial artery catheter. down was measured during abdominal exploration (baseline), after fluid loading, before and following tumour resection, and during treatment of arterial hypotension.

Results: At baseline, down ranged between 1 and 15 mmHg (median: 3 mmHg). Volume loading (500 mL colloid over 20 min) performed during abdominal exploration significantly reduced down (P = 0.001) and resulted in down values 2 mmHg in all 13 patients. The down measured immediately before resection was larger in patients who had arterial hypotension (systolic arterial pressure (SAP) < 90 mmHg) following tumour removal than in other patients [4 (1–10) vs 1 (0–3) mmHg; P = 0.04]. During hypotension, down was greater in patients where fluid replacement restored SAP than in patients where fluids were ineffective and vasopressors needed [down: 4 (3–9) vs 1 (1–2) mmHg; P = 0.03].

Conclusion: During pheochromocytoma surgery, a down 2 mmHg appears to indicate minimal intravascular volume depletion. down measurements could be used to guide fluid therapy for the prevention and treatment of arterial hypotension following pheochromocytoma removal.

This article has been cited by other articles:

				C. Runcie, B. Tavernier, H. Solus-Biguenet, M. Fleyfel, and B. Vallet Predicting fluid responsiveness in theatre Br. J. Anaesth., April 1, 2007; 98(4): 545 - 547. [Full Text] [PDF]