{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,12]],"date-time":"2026-09-12T09:06:18Z","timestamp":1789203978409,"version":"build-2803163510"},"reference-count":29,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2007,3,14]],"date-time":"2007-03-14T00:00:00Z","timestamp":1173830400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Acta Anaesthesiol Scand"],"published-print":{"date-parts":[[2007,4]]},"abstract":"<jats:p><jats:bold>Background:\u2002<\/jats:bold> Increases in positive end\u2010expiratory pressure (PEEP) are often associated with cardiovascular depression, responding to fluid loading. Therefore, we hypothesized that if stroke volume (SV) is reduced by an increase in PEEP this reduction is an indicator of hypovolemia or preload responsiveness, i.e. that SV would increase by fluid administration at zero end\u2010expiratory pressure (ZEEP). The relationship between the cardiovascular response to different PEEP levels and fluid load as well as the relation between change in SV as a result of change in preload (Frank\u2013Starling relationship) were evaluated in a porcine model. In addition, other measures of fluid status were assessed.<\/jats:p><jats:p><jats:bold>Methods:\u2002<\/jats:bold> Eight, 20\u201322 kg, anesthetized, mechanically ventilated pigs were subjected to 0, 10, and 20 cm H<jats:sub>2<\/jats:sub>O PEEP at 10% (of estimated blood volume) hypovolemia, normo\u2010 and 10% hypervolemia, and to ZEEP at 20% hypervolemia. SV, cardiac output, intrathoracic blood volume and airway, esophageal, vascular pressures, stroke volume variations, left ventricular end\u2010diastolic and end\u2010systolic areas and respiratory variations in the diameter of the inferior vena cava were obtained.<\/jats:p><jats:p><jats:bold>Results:\u2002<\/jats:bold>  At hypovolemia and normovolemia, 10 cm H<jats:sub>2<\/jats:sub>O PEEP induced a significant decrease in SV, while no change occurred at 10% hypervolemia. SV measured at ZEEP increased from hypovolemia to normovolemia and 10% hypervolemia, while no change was found between 10% and 20% hypervolemia. The sensitivity and specificity decrease in SV by PEEP indicating an increase in SV by fluids was 60\u201388% and 67%, respectively, depending on the volemic (preload) levels.<\/jats:p><jats:p><jats:bold>Conclusion:\u2002<\/jats:bold>  Although the overall results suggest that a change in SV by PEEP might predict preload responsiveness, the individual response of SV by 10 cm H<jats:sub>2<\/jats:sub>O PEEP and of the successive fluid administration seemed to be dependent on where on the Frank\u2013Starling curve the heart function was located.<\/jats:p>","DOI":"10.1111\/j.1399-6576.2007.01248.x","type":"journal-article","created":{"date-parts":[[2007,3,15]],"date-time":"2007-03-15T02:09:21Z","timestamp":1173924561000},"page":"415-425","source":"Crossref","is-referenced-by-count":25,"title":["Does a positive end\u2010expiratory pressure\u2010induced reduction in stroke volume indicate preload responsiveness? 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