The Clinical Relevance of Systolic Pressure Variations in Anesthetized Nonhypotensive Patients

Abstract Objective: To assess the accuracy of respiratory-induced systolic pressure variation and its components to detect low left ventricular preload. Design: Prospective study. Setting: University hospital. Participants: Sixty-seven patients undergoing major surgery under general anesthesia. Interventions: Transesophageal echocardiographic measurements during apnea and mechanical ventilation. Measurements and Main Results: Respiratory-induced systolic pressure variation and its components and left ventricular end-diastolic area obtained by transesophageal echocardiography were noted simultaneously. Arterial pressure indices did not allow a reliable diagnosis of a low left ventricular end-diastolic area using a cut-off value of 7.9 cm 2 /m 2 (inferior boundary of the interquartile range of the areas measured in the authors' group). Conclusions: These results suggest that systolic pressure variations noticed after induction of general anesthesia do not reflect low left ventricular preload in nonhypotensive patients. © 2003 Elsevier Inc. All rights reserved.