Wiesenack, Christoph and Fiegl, Christoph and Keyser, Andreas and Prasser, Christopher and Keyl, C. (2005) Assessment of fluid responsiveness in mechanically ventilated cardiac surgical patients. EUROPEAN JOURNAL OF ANAESTHESIOLOGY, 22 (9). pp. 658-665. ISSN 0265-0215, 1365-2346
Full text not available from this repository. (Request a copy)Abstract
Background and objective: Accurate assessment of preload responsiveness is an important goal of the clinician to avoid deleterious volume replacement associated with increased morbidity and mortality in mechanically ventilated patients. This study was designed to evaluate the accuracy of simultaneously assessed stroke volume variation and pulse pressure variation using an improved algorithm for pulse contour analysis (PiCCO plus (R), V 5.2.2), compared to the respiratory changes in transoesophageal echo-derived aortic blood velocity (Delta Vpeak), intrathoracic blood volume index, central venous pressure and pulmonary capillary wedge pressure to predict the response of stroke volume index to volume replacement in normoventilated cardiac surgical patients. Methods: We studied 20 patients undergoing elective coronary artery bypass grafting. After induction of anaesthesia, haemodynamic measurements were performed before and after volume replacement by infusion of 6% hydroxyethyl starch 200/0.5 (7 mL kg(-1)) with a rate of I mL kg(-1) min(-1). Results: Baseline stroke volume variation correlated significantly with changes in stroke volume index (Delta SVI) (r(2) = 0.66; P < 0.05) as did baseline pulse pressure variation (r(2) = 0.65; P < 0.05), whereas baseline values of Delta Vpeak, intrathoracic blood volume index, central venous pressure and pulmonary artery wedge pressure showed no correlation to Delta SVI. Pulse contour analysis underestimated the volume-induced increase in cardiac index measured by transpulmonary thermodilution (P < 0.05). Conclusions: The results of our study suggest that stroke volume variation and its surrogate pulse pressure variation derived from pulse contour analysis using an improved algorithm can serve as indicators of fluid responsiveness in normoventilated cardiac surgical patients. Whenever changes in systemic vascular resistance are expected, the PiCCO plus (R) system should be recalibrated.
| Item Type: | Article |
|---|---|
| Uncontrolled Keywords: | PULSE-CONTOUR ANALYSIS; STROKE VOLUME VARIATION; SYSTOLIC PRESSURE VARIATION; RESPIRATORY CHANGES; THERMODILUTION TECHNIQUE; INTENSIVE-CARE; SURGERY; PRELOAD; INDICATOR; PARAMETERS; CARDIAC SURGICAL PROCEDURES, coronary artery bypass grafting; HAEMODYNAMIC PHENOMENA, fluid response, stroke volume variation, pulse pressure variation, aortic blood velocity, pulse contour analysis; CRITICAL CARE; CARDIAC OUTPUT |
| Subjects: | 600 Technology > 610 Medical sciences Medicine |
| Divisions: | Medicine > Lehrstuhl für Anästhesiologie Medicine > Lehrstuhl für Herz-, Thorax- und herznahe Gefäßchirurgie |
| Depositing User: | Dr. Gernot Deinzer |
| Date Deposited: | 27 Apr 2021 12:25 |
| Last Modified: | 27 Apr 2021 12:25 |
| URI: | https://pred.uni-regensburg.de/id/eprint/35677 |
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