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Commentary

Why do pulse pressure variations fail to predict the response to fluids in acute respiratory distress syndrome patients ventilated with low tidal volume?

Daniel De Backer* and Sabino Scolletta

Author Affiliations

Department of Intensive Care, Erasme University Hospital, Université Libre de Bruxelles, B-1070 Brussels, Belgium

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Critical Care 2011, 15:150  doi:10.1186/cc10111


See related research by Lakhal et al., http://ccforum.com/content/15/2/R85 and related letter by Mallat et al., http://ccforum.com/content/15/3/432

Published: 12 April 2011

Abstract

Respiratory-associated variations in stroke volume and pulse pressure are frequently used to predict the response to fluid administration. However, it has been demonstrated that low tidal volume ventilation may limit their use in patients with acute respiratory distress syndrome (ARDS). In this issue, a trial investigates the value of pulse pressure variation to predict fluid responsiveness in a large series of patients with ARDS ventilated according to current guidelines.