Cyclic Nonrespiratory Pulse Pressure Oscillations Caused by Atrioventricular Dissociation

Dynamic preload assessment tests, especially pulse pressure variation (PPV) and stroke volume variation (SVV), are increasingly acknowledged in mechanically ventilated patients as being predictors of fluid responsiveness. However, the limitations of this method are often neglected or overlooked. One...

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Main Authors: László Rudas, Péter Hankovszky, András Lovas, Éva Zöllei, Zsolt Molnár
Format: Article
Language:English
Published: Wiley 2017-01-01
Series:Case Reports in Critical Care
Online Access:http://dx.doi.org/10.1155/2017/7647069
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author László Rudas
Péter Hankovszky
András Lovas
Éva Zöllei
Zsolt Molnár
author_facet László Rudas
Péter Hankovszky
András Lovas
Éva Zöllei
Zsolt Molnár
author_sort László Rudas
collection DOAJ
description Dynamic preload assessment tests, especially pulse pressure variation (PPV) and stroke volume variation (SVV), are increasingly acknowledged in mechanically ventilated patients as being predictors of fluid responsiveness. However, the limitations of this method are often neglected or overlooked. One of the prerequisites for PPV and SVV evaluation, in addition to intermittent positive pressure ventilation, is a “regular heart rhythm,” which may be an ambiguous term. We present a case where, despite a regular (paced) rhythm, atrioventricular dissociation was present and resulted in marked PPV elevation, which subsequently disappeared once sinus rhythm returned. Our case indicates that PPV and SVV should be interpreted with caution when atrioventricular dissociation is present.
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publishDate 2017-01-01
publisher Wiley
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series Case Reports in Critical Care
spelling doaj-art-ad14f3ffc1e24107bfcecfce5b21c2572025-08-20T02:20:37ZengWileyCase Reports in Critical Care2090-64202090-64392017-01-01201710.1155/2017/76470697647069Cyclic Nonrespiratory Pulse Pressure Oscillations Caused by Atrioventricular DissociationLászló Rudas0Péter Hankovszky1András Lovas2Éva Zöllei3Zsolt Molnár4Department of Anesthesiology and Intensive Care, Faculty of Medicine, University of Szeged, Szeged, HungaryDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, University of Szeged, Szeged, HungaryDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, University of Szeged, Szeged, HungaryDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, University of Szeged, Szeged, HungaryDepartment of Anesthesiology and Intensive Care, Faculty of Medicine, University of Szeged, Szeged, HungaryDynamic preload assessment tests, especially pulse pressure variation (PPV) and stroke volume variation (SVV), are increasingly acknowledged in mechanically ventilated patients as being predictors of fluid responsiveness. However, the limitations of this method are often neglected or overlooked. One of the prerequisites for PPV and SVV evaluation, in addition to intermittent positive pressure ventilation, is a “regular heart rhythm,” which may be an ambiguous term. We present a case where, despite a regular (paced) rhythm, atrioventricular dissociation was present and resulted in marked PPV elevation, which subsequently disappeared once sinus rhythm returned. Our case indicates that PPV and SVV should be interpreted with caution when atrioventricular dissociation is present.http://dx.doi.org/10.1155/2017/7647069
spellingShingle László Rudas
Péter Hankovszky
András Lovas
Éva Zöllei
Zsolt Molnár
Cyclic Nonrespiratory Pulse Pressure Oscillations Caused by Atrioventricular Dissociation
Case Reports in Critical Care
title Cyclic Nonrespiratory Pulse Pressure Oscillations Caused by Atrioventricular Dissociation
title_full Cyclic Nonrespiratory Pulse Pressure Oscillations Caused by Atrioventricular Dissociation
title_fullStr Cyclic Nonrespiratory Pulse Pressure Oscillations Caused by Atrioventricular Dissociation
title_full_unstemmed Cyclic Nonrespiratory Pulse Pressure Oscillations Caused by Atrioventricular Dissociation
title_short Cyclic Nonrespiratory Pulse Pressure Oscillations Caused by Atrioventricular Dissociation
title_sort cyclic nonrespiratory pulse pressure oscillations caused by atrioventricular dissociation
url http://dx.doi.org/10.1155/2017/7647069
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AT evazollei cyclicnonrespiratorypulsepressureoscillationscausedbyatrioventriculardissociation
AT zsoltmolnar cyclicnonrespiratorypulsepressureoscillationscausedbyatrioventriculardissociation