| Evaluation of stroke volume variation obtained by arterial pulse contour analysis to predict fluid responsiveness intraoperatively. | |
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MedLine Citation:
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PMID: 19628484 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: Fluid management guided by oesophageal Doppler monitor has been reported to improve perioperative outcome. Stroke volume variation (SVV) is considered a reliable clinical predictor of fluid responsiveness. Consequently, the aim of the present trial was to evaluate the accuracy of SVV determined by arterial pulse contour (APCO) analysis, using the FloTrac/Vigileo system, to predict fluid responsiveness as measured by the oesophageal Doppler. METHODS: Patients undergoing major abdominal surgery received intraoperative fluid management guided by oesophageal Doppler monitoring. Fluid boluses of 250 ml each were administered in case of a decrease in corrected flow time (FTc) to <350 ms. Patients were connected to a monitoring device, obtaining SVV by APCO. Haemodynamic variables were recorded before and after fluid bolus application. Fluid responsiveness was defined as an increase in stroke volume index >10%. The ability of SVV to predict fluid responsiveness was assessed by calculation of the area under the receiver operating characteristic (ROC) curve. RESULTS: Twenty patients received 67 fluid boluses. Fifty-two of the 67 fluid boluses administered resulted in fluid responsiveness. SVV achieved an area under the ROC curve of 0.512 [confidence interval (CI) 0.32-0.70]. A cut-off point for fluid responsiveness was found for SVV > or =8.5% (sensitivity: 77%; specificity: 43%; positive predictive value: 84%; and negative predictive value: 33%). CONCLUSIONS: This prospective, interventional observer-blinded study demonstrates that SVV obtained by APCO, using the FloTrac/Vigileo system, is not a reliable predictor of fluid responsiveness in the setting of major abdominal surgery. |
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Authors:
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D Lahner; B Kabon; C Marschalek; A Chiari; G Pestel; A Kaider; E Fleischmann; H Hetz |
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Publication Detail:
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Type: Evaluation Studies; Journal Article Date: 2009-07-23 |
Journal Detail:
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Title: British journal of anaesthesia Volume: 103 ISSN: 1471-6771 ISO Abbreviation: Br J Anaesth Publication Date: 2009 Sep |
Date Detail:
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Created Date: 2009-08-14 Completed Date: 2009-09-03 Revised Date: 2009-11-17 |
Medline Journal Info:
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Nlm Unique ID: 0372541 Medline TA: Br J Anaesth Country: England |
Other Details:
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Languages: eng Pagination: 346-51 Citation Subset: IM |
Affiliation:
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Department of Anaesthesiology, General Intensive Care and Pain Control, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria. daniel.lahner@meduniwien.ac.at |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Abdomen
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surgery Adult Aged Algorithms Echocardiography, Transesophageal Epidemiologic Methods Female Fluid Therapy / methods Hemodynamics Humans Intraoperative Care / methods Male Middle Aged Monitoring, Intraoperative / methods* Signal Processing, Computer-Assisted Stroke Volume* |
| Comments/Corrections | |
Comment In:
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Br J Anaesth. 2009 Dec;103(6):896-7; author reply 897-9
[PMID:
19918025
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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