Evaluation of stroke volume variation obtained by arterial pulse contour analysis to predict fluid responsiveness intraoperatively Export

@article{citeulike:5686231, abstract = {BackgroundFluid 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 FloTracTM/VigileoTM system, to predict fluid responsiveness as measured by the oesophageal Doppler. MethodsPatients 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. ResultsTwenty 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 [\&ge;]8.5\% (sensitivity: 77\%; specificity: 43\%; positive predictive value: 84\%; and negative predictive value: 33\%). ConclusionsThis prospective, interventional observer-blinded study demonstrates that SVV obtained by APCO, using the FloTracTM/VigileoTM system, is not a reliable predictor of fluid responsiveness in the setting of major abdominal surgery. 10.1093/bja/aep200}, author = {Lahner, D. and Kabon, B. and Marschalek, C. and Chiari, A. and Pestel, G. and Kaider, A. and Fleischmann, E. and Hetz, H.}, citeulike-article-id = {5686231}, citeulike-linkout-0 = {http://dx.doi.org/10.1093/bja/aep200}, citeulike-linkout-1 = {http://bja.oxfordjournals.org/cgi/content/abstract/103/3/346}, citeulike-linkout-2 = {http://view.ncbi.nlm.nih.gov/pubmed/19628484}, citeulike-linkout-3 = {http://www.hubmed.org/display.cgi?uids=19628484}, day = {1}, doi = {10.1093/bja/aep200}, journal = {Br. J. Anaesth.}, keywords = {audit, doppler, oesophageal, svv}, month = {September}, number = {3}, pages = {346--351}, posted-at = {2009-08-30 22:26:00}, priority = {2}, title = {Evaluation of stroke volume variation obtained by arterial pulse contour analysis to predict fluid responsiveness intraoperatively}, url = {http://dx.doi.org/10.1093/bja/aep200}, volume = {103}, year = {2009} }

TY - JOUR ID - citeulike:5686231 L3 - citeulike-article-id:5686231 N2 - BackgroundFluid 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 FloTracTM/VigileoTM system, to predict fluid responsiveness as measured by the oesophageal Doppler. MethodsPatients 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. ResultsTwenty 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 [&ge;]8.5% (sensitivity: 77%; specificity: 43%; positive predictive value: 84%; and negative predictive value: 33%). ConclusionsThis prospective, interventional observer-blinded study demonstrates that SVV obtained by APCO, using the FloTracTM/VigileoTM system, is not a reliable predictor of fluid responsiveness in the setting of major abdominal surgery. 10.1093/bja/aep200 IS - 3 JF - Br. J. Anaesth. EP - 351 TI - Evaluation of stroke volume variation obtained by arterial pulse contour analysis to predict fluid responsiveness intraoperatively VL - 103 SP - 346 KW - audit KW - doppler KW - oesophageal KW - svv AU - Lahner, D AU - Kabon, B AU - Marschalek, C AU - Chiari, A AU - Pestel, G AU - Kaider, A AU - Fleischmann, E AU - Hetz, H PY - 2009/09/01/ UR - http://dx.doi.org/10.1093/bja/aep200 ER -