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Measurement of Systolic Pressure Variation on a Datex AS/3 Monitor

Gouvêa, Glauber MD; Gouvêa, Fabiano Gomes MD

doi: 10.1213/01.ANE.0000156681.36240.10
Letters to the Editor: Letters & Announcements

Department of Anesthesiology, Liver Transplantation Program, Hospital Geral de Bonsucesso, glaubergouvea@ibest.com.br (G. Gouvêa)

Department of Anesthesiology, Hospital dos Servidores do Estado, Rio de Janeiro, Brazil (F. Gouvêa)

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To the Editor:

Systolic blood pressure variation represents a method to estimate intravascular volume, and many studies have confirmed its role in the diagnosis of hypovolemia (1–3). Recently, a new monitor for on-line systolic blood pressure variation measurement has been developed (4); however, one of its limitations may be its cost, which was not addressed by the authors.

We describe a bedside technique to quantify systolic blood pressure variation on a Datex monitor (Figs. 1 and 2). In the invasive pressures channel, there is a “wedge pressure” menu. The technique is to use this wedge pressure function but instead apply it on the systemic arterial curve as follows:

Figure 1

Figure 1

Figure 2

Figure 2

  1. Label the systemic arterial blood pressure curve as “pulmonary arterial pressure” and change the scale accordingly.
  2. Next, enter the “wedge pressure” menu. Push the comwheel to confirm; the screen will freeze and a blue horizontal line will appear. You are now free to move it to the uppermost point of the curve, and then move it down to the lowest systolic pressure (note the paw curve above for reference). The difference between them is the systolic blood pressure variation.

This method is a simple and easy-to-learn way to measure the systolic blood pressure variation with no additional costs, and it may prove itself useful for clinicians who desire to guide fluid therapy based on systolic blood pressure variation trends quantified at bedside.

Glauber Gouvêa, MD

Department of Anesthesiology

Liver Transplantation Program

Hospital Geral de Bonsucesso

glaubergouvea@ibest.com.br

Fabiano Gomes Gouvêa, MD

Department of Anesthesiology

Hospital dos Servidores do Estado

Rio de Janeiro, Brazil

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References

1. Perel A, Pizov R, Cotev S. Systolic blood pressure variation is a sensitive indicator of hypovolemia in mechanically ventilated dogs subjected to graded hemorrhage. Anesthesiology 1987;67:498–502.
2. Tavernier B, Makhotine O, Lebuffe G, et al. Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology 1998;89:1313–21.
3. Perel A. Assessing fluid responsiveness by the systolic pressure variation in mechanically ventilated patients. Anesthesiology 1998;89:1309–10.
4. Fujita Y, Sari A, Yamamoto T. On-line monitoring of systolic pressure variation. Anesth Analg 2003;96:1529–30.
© 2005 International Anesthesia Research Society