Effect of positive end-expiratory pressure on functional hemodynamic parameters in patients in lateral position during operation

Objective To investigate the effect of positive end-expiratory pressure(PEEP) on functional hemodynamic parameters in patients lying in left lateral position during operation(right side total hip arthroplasty) under general anesthesia.Methods Twenty patients undergoing right side total hip arthroplasty lying in left lateral position under general anesthesia from March to August of 2013 were enrolled in the present study.The mechanical ventilation and PEEP were used in all of the patients,the functional hemodynamic parameters including stroke volume variation(SVV) and pulse pressure variation(PPV),and the circulatory parameters consisting of cardiac index(CI),mean arterial pressure(MAP) and heart rate(HR) under PEEP levels of 0cmH2O(P0),4cmH2O(P4),6cmH2O(P6),8cmH2O(P8),10cmH2O(P10),12cmH2O(P12) and 14cmH2O(P14) were recorded.Results Along with the elevation of PEEP,SVV and PPV increased and exhibited a positive correlation with PEEP levels(r=0.507,r=0.359,P0.01),while CI gradually lowered,and it exhibited a negative correlation with PEEP levels(r=–0.108,P0.05).MAP and HR showed no significant change with different PEEP levels(P0.05).Conclusion The influence of PEEP on SVV and PPV must be considered when they are used to monitor volume status in order to avoid misjudgment of volume status.