Document Detail


Accuracy of stroke volume variation compared with pleth variability index to predict fluid responsiveness in mechanically ventilated patients undergoing major surgery.
MedLine Citation:
PMID:  20035228     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND AND OBJECTIVE: Accurate assessment of a patient's volume status is an important goal for an anaesthetist. However, most variables assessing fluid responsiveness are either invasive or technically challenging. This study was designed to compare the accuracy of arterial pressure-based stroke volume variation (SVV) and variations in the pulse oximeter plethysmographic waveform amplitude as evaluated with the noninvasive calculated pleth variability index (PVI) with central venous pressure to predict the response of stroke volume index (SVI) to volume replacement in patients undergoing major surgery. METHODS: We studied 20 patients scheduled for elective major abdominal surgery. After induction of anaesthesia, all haemodynamic variables were recorded immediately before (T1) and subsequent to volume replacement (T2) by infusion of 6% hydroxy-ethyl starch (HES) 130/0.4 (7 ml kg) at a rate of 1 ml kg min. RESULTS: The volume-induced increase in SVI was at least 15% in 15 patients (responders) and less than 15% in five patients (nonresponders). Baseline SVV correlated significantly with changes in SVI (DeltaSVI; r = 0.80; P < 0.001) as did baseline PVI (r = 0.61; P < 0.004), whereas baseline values of central venous pressure showed no correlation to DeltaSVI. There was no significant difference between the area under the receiver operating characteristic curve for SVV (0.993) and PVI (0.973). The best threshold values to predict fluid responsiveness were more than 11% for SVV and more than 9.5% for PVI. CONCLUSION: Although arterial pressure-derived SVV revealed the best correlation to volume-induced changes in SVI, the results of our study suggest that both variables, SVV and PVI, can serve as valid indicators of fluid responsiveness in mechanically ventilated patients undergoing major surgery.
Authors:
Markus Zimmermann; Thomas Feibicke; Cornelius Keyl; Christopher Prasser; Stefan Moritz; Bernhard M Graf; Christoph Wiesenack
Related Documents :
24005958 - Infliximab, a tnf-α inhibitor, reduces 24-h ambulatory blood pressure in rheumatoid ar...
18351378 - High day-to-day reliability in lower leg volume measured by water displacement.
8064188 - A method for predicting the volume of an ileo-anal pouch.
21691318 - Managing kidney disease with blood-pressure control.
3605848 - Effects of removing oxygen from patients with chronic obstructive pulmonary disease.
1661758 - Higher na(+)-h+ exchange rate and more alkaline intracellular ph set-point in essential...
Publication Detail:
Type:  Comparative Study; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  European journal of anaesthesiology     Volume:  27     ISSN:  1365-2346     ISO Abbreviation:  Eur J Anaesthesiol     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-05-05     Completed Date:  2010-11-12     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8411711     Medline TA:  Eur J Anaesthesiol     Country:  England    
Other Details:
Languages:  eng     Pagination:  555-61     Citation Subset:  IM    
Affiliation:
Department of Anaesthesiology, University Hospital Regensburg, Regensburg, Germany.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Blood Pressure / physiology
Female
Fluid Therapy / methods*
Hemodynamics / drug effects,  physiology
Hetastarch / administration & dosage
Humans
Male
Middle Aged
Monitoring, Intraoperative / methods*
Plasma Substitutes / administration & dosage
Plethysmography / methods*
ROC Curve
Respiration, Artificial / methods*
Respiratory Mechanics
Stroke Volume / physiology*
Surgical Procedures, Elective / methods
Chemical
Reg. No./Substance:
0/Plasma Substitutes; 9005-27-0/Hetastarch

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


Previous Document:  Sevoflurane-emergence agitation: effect of supplementary low-dose oral ketamine premedication in pre...
Next Document:  Bispectral index variations in patients with neurological deficits during awake carotid endarterecto...