Augmented Pulse Pressure Variation to Predict Fluid Responsiveness in Open Laparotomy

Pulse Pressure Variation With Augmented Ventilation to Predict Fluid Responsiveness in the Patients Undergoing Open Laparotomy Surgery

Pulse pressure variation (PPV) is a well-known and widely used dynamic preload indicator based on heart-lung interaction to predict fluid responsiveness. Generally, patients are considered to be fluid-responsive when the PPV value larger than 11-13%. However, several previous researches demonstrated that there is a zone of uncertainty (grey zone) in PPV. To predict fluid-responsiveness accurately in the patients with PPV within grey zone (9-13%), the investigators would evaluate the augmented PPV using augmented ventilation.

Inclusion Criteria:

• Adult patients undergoing elective open laparotomy surgery.

Exclusion Criteria:

• Irregular heart beats,
• cardiac arrhythmia,
• moderate or severe valvular heart disease,
• preoperative left ventriular ejection fraction less than 40%,
• moderate t severe obstructive pulmonary disease,
• preoperative need of inotropics infusion,
• preoperative serum Cr > 1.3ml/dl,
• moderate to severe renal or liver disease,
• acute lung injury or acute lung problem,
• coexisting open chest condition,
• severe bradycardia,
• patients with spontaneous breathing