Document Detail


Automated pulse pressure and stroke volume variations from radial artery: evaluation during major abdominal surgery.
MedLine Citation:
PMID:  19797246     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Off-line calculation of the pulse pressure variation (PPV(ref)) has repeatedly been shown to be a reliable predictor of fluid responsiveness in mechanically ventilated patients. This study was designed to assess the ability of two algorithms for automated calculation of PPV (PPV(auto)) (Intellivue MP 70) and stroke volume variation (SVV(auto)) (FloTrac/Vigileo) to predict fluid responsiveness during abdominal surgery. METHODS: We conducted a prospective study of 56 fluid challenges given for haemodynamic instability in 11 patients undergoing major abdominal surgery. Fluid responsiveness was defined as an increase in stroke volume index (SVI) >10%. PPV(ref), PPV(auto), SVV(auto), and SVI (oesophageal Doppler) were recorded simultaneously before and after each fluid challenge. RESULTS: PPV(auto) and SVV(auto) both correlated with PPV(ref) [r(corr)=0.87 (P<0.0001) and 0.84 (P<0.0001), respectively; n=77]. All three indices measured before fluid challenges were higher in responder (n=32) than in non-responder (n=24) fluid challenges (P < or = 0.02). The mean areas under the receiver operating characteristic curves were 0.96 (PPV(ref)), 0.96 (PPV(auto)), and 0.95 (SVV(auto)), and the optimal threshold value for each variable was 13%, 13%, and 12%, respectively. All indices correlated with the fluid challenge-induced changes in SVI (PPV(ref): r(corr)=0.65; PPV(auto): r(corr)=0.58; SVV(auto): r(corr)=0.58, P<0.001 for all). CONCLUSIONS: PPV(auto) and SVV(auto) predict fluid responsiveness as accurately as off-line PPV(ref) in patients with haemodynamic instability during major abdominal surgery.
Authors:
A Derichard; E Robin; B Tavernier; M Costecalde; M Fleyfel; J Onimus; G Lebuffe; J-P Chambon; B Vallet
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Publication Detail:
Type:  Evaluation Studies; Journal Article     Date:  2009-09-29
Journal Detail:
Title:  British journal of anaesthesia     Volume:  103     ISSN:  1471-6771     ISO Abbreviation:  Br J Anaesth     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-19     Completed Date:  2009-12-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  0372541     Medline TA:  Br J Anaesth     Country:  England    
Other Details:
Languages:  eng     Pagination:  678-84     Citation Subset:  IM    
Affiliation:
Federation of Anesthesiology and Critical Care Medicine, Centre Hospitalier Universitaire de Lille, Lille, France.
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MeSH Terms
Descriptor/Qualifier:
Abdomen / surgery*
Aged
Algorithms
Blood Pressure / physiology*
Fluid Therapy
Humans
Intraoperative Care / methods
Middle Aged
Monitoring, Intraoperative / methods*
Prospective Studies
Radial Artery / physiopathology*
Signal Processing, Computer-Assisted
Stroke Volume / physiology*

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


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