PURPOSE: The ability of the global end-diastolic volume index (GEDVI) and respiratory variations in left ventricular outflow tract velocity (ΔVTI(LVOT)) for prediction of fluid responsiveness is still under debate. The aim of the present study was to challenge the predictive power of GEDVI and ΔVTI(LVOT) compared with pulse pressure variation (PPV) and stroke volume variation (SVV) in a large patient population. MATERIAL AND METHODS: Ninety-two patients were studied before coronary artery surgery. Each patient was monitored with central venous pressure (CVP), the PiCCO system (Pulsion Medical Systems, Munich, Germany), and transesophageal echocardiography. Responders were defined as those who increased their stroke volume index by greater than 15% (ΔSVI(TPTD) >15%) during passive leg raising. RESULTS: Central venous pressure showed no significant correlation with ΔSVI(TPTD) (r = -0.06, P = .58), in contrast to PPV (r = 0.71, P < .0001), SVV (r = 0.61, P < .0001), GEDVI (r = -0.54, P < .0001), and ΔVTI(LVOT) (r = 0.54, P < .0001). The best area under the receiver operating characteristic curve (AUC) predicting ΔSVI(TPTD) greater than 15% was found for PPV (AUC, 0.82; P < .0001) and SVV (AUC, 0.77; P < .0001), followed by ΔVTI(LVOT) (AUC, 0.74; P < .0001) and GEDVI (AUC, 0.71; P = .0006), whereas CVP was not able to predict fluid responsiveness (AUC, 0.58; P = .18). CONCLUSIONS: In contrast to CVP, GEDVI and ΔVTI(LVOT) reliably predicted fluid responsiveness under closed-chest conditions. Pulse pressure variation and SVV showed the highest accuracy.
PURPOSE: The ability of the global end-diastolic volume index (GEDVI) and respiratory variations in left ventricular outflow tract velocity (ΔVTI(LVOT)) for prediction of fluid responsiveness is still under debate. The aim of the present study was to challenge the predictive power of GEDVI and ΔVTI(LVOT) compared with pulse pressure variation (PPV) and stroke volume variation (SVV) in a large patient population. MATERIAL AND METHODS: Ninety-two patients were studied before coronary artery surgery. Each patient was monitored with central venous pressure (CVP), the PiCCO system (Pulsion Medical Systems, Munich, Germany), and transesophageal echocardiography. Responders were defined as those who increased their stroke volume index by greater than 15% (ΔSVI(TPTD) >15%) during passive leg raising. RESULTS: Central venous pressure showed no significant correlation with ΔSVI(TPTD) (r = -0.06, P = .58), in contrast to PPV (r = 0.71, P < .0001), SVV (r = 0.61, P < .0001), GEDVI (r = -0.54, P < .0001), and ΔVTI(LVOT) (r = 0.54, P < .0001). The best area under the receiver operating characteristic curve (AUC) predicting ΔSVI(TPTD) greater than 15% was found for PPV (AUC, 0.82; P < .0001) and SVV (AUC, 0.77; P < .0001), followed by ΔVTI(LVOT) (AUC, 0.74; P < .0001) and GEDVI (AUC, 0.71; P = .0006), whereas CVP was not able to predict fluid responsiveness (AUC, 0.58; P = .18). CONCLUSIONS: In contrast to CVP, GEDVI and ΔVTI(LVOT) reliably predicted fluid responsiveness under closed-chest conditions. Pulse pressure variation and SVV showed the highest accuracy.
Authors: Ole Broch; Matthias Gruenewald; Jochen Renner; Patrick Meybohm; Jan Schöttler; Katharina Heß; Markus Steinfath; Berthold Bein Journal: PLoS One Date: 2013-02-13 Impact factor: 3.240
Authors: Zhong Yuanbo; Wang Jin; Shi Fei; Long Liangong; Liu Xunfa; Xu Shihai; Shan Aijun Journal: Ann Intensive Care Date: 2016-11-21 Impact factor: 6.925