- Oral presentation
- Open Access
The Mini-Sigh Test: A New Haemodynamic Test of Fluid Responsiveness in Icu Patients Undergoing Pressure Support Ventilation
© Messina et al.; 2015
- Published: 1 October 2015
- Pulse Pressure
- Pressure Support
- Fluid Responsiveness
- Pressure Support Ventilation
- Pulse Pressure Variation
Dynamic predictors of fluid responsiveness (FR) perform poorly in ICU patients receiving partial ventilatory assistance. Because these modes of partial support are increasingly used, FR dynamic indexes are applicable only in a few ICU patients . To overcome these limitations, novel approaches for testing FR in ICU have been proposed, such as the passive leg raising and the end-expiratory occlusion. These tests, however, may not always be applicable . During controlled mechanical ventilation, Pulse Pressure (PP) and left ventricle stroke volume are coupled; their variations are due to the reduction of right ventricle stroke volume consequent to ventilator insufflation and are either proportional to the tidal volume and closely related to preload dependence.
We hypothesize that during Pressure Support (PS) a brief variation in intrathoracic pressure, such as that produced by a deeper inflation lasting some seconds, would differently affect PP in fluid responder and non-responders.
In hemodynamically unstable patients undergoing PS, ΔPP_Nadir determined adding SIGH_35, while not SIGH_15 and SIGH_25, allows assessment of FR.
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.