Jae-Kwang Shim1, Jong-Wook Song1, Young Song1, Ji-Ho Kim2, Hye-Min Kang3, Young-Lan Kwak4. 1. Department of Anesthesiology and Pain Medicine, Yonsei University Health System, Seoul, 120-752, South Korea; Anesthesia and Pain Research Institute, Yonsei University Health System, Seoul, 120-752, South Korea. 2. Department of Anesthesiology and Pain Medicine, National Health Insurance Service Ilsan Hospital, Goyang City, Gyeonggi-do, 410-719, South Korea. 3. Department of Anesthesiology and Pain Medicine, Yonsei University Health System, Seoul, 120-752, South Korea. 4. Department of Anesthesiology and Pain Medicine, Yonsei University Health System, Seoul, 120-752, South Korea; Anesthesia and Pain Research Institute, Yonsei University Health System, Seoul, 120-752, South Korea. Electronic address: ylkwak64@gmail.com.
Abstract
PURPOSE: The purpose of this study was to test the hypothesis that the predictive ability of pulse pressure variation (PPV) for fluid responsiveness would be altered in patients with elevated left ventricular (LV) filling pressure. MATERIALS AND METHODS: According to the preoperative echocardiographic assessment of the ratio of early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/E'), patients undergoing surgical coronary revascularization were classified into normal (n=34, E/E'<8) and high (n=34, E/E'>15) LV filling pressure group. After anesthetic induction, PPV and hemodynamic data were measured before and after 6 mL/kg of colloid administration. Fluid responsiveness was defined as 12% or more increase in stroke volume index assessed by pulmonary artery catheter and tested by the area under the receiver operating characteristic curve (AUROC). RESULTS: The AUROCs of PPV in the normal and high filling pressure group were 0.829 (95% confidence interval [CI], 0.661-0.963; P<.001) and 0.583 (95% CI, 0.402-0.749; P=.110), respectively. The AUROCs of cardiac filling pressures and right ventricular end-diastolic volume index did not show statistical significance in both groups. CONCLUSIONS: None of the assessed preload indices including PPV were able to predict fluid responsiveness in patients with elevated LV filling pressure.
PURPOSE: The purpose of this study was to test the hypothesis that the predictive ability of pulse pressure variation (PPV) for fluid responsiveness would be altered in patients with elevated left ventricular (LV) filling pressure. MATERIALS AND METHODS: According to the preoperative echocardiographic assessment of the ratio of early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/E'), patients undergoing surgical coronary revascularization were classified into normal (n=34, E/E'<8) and high (n=34, E/E'>15) LV filling pressure group. After anesthetic induction, PPV and hemodynamic data were measured before and after 6 mL/kg of colloid administration. Fluid responsiveness was defined as 12% or more increase in stroke volume index assessed by pulmonary artery catheter and tested by the area under the receiver operating characteristic curve (AUROC). RESULTS: The AUROCs of PPV in the normal and high filling pressure group were 0.829 (95% confidence interval [CI], 0.661-0.963; P<.001) and 0.583 (95% CI, 0.402-0.749; P=.110), respectively. The AUROCs of cardiac filling pressures and right ventricular end-diastolic volume index did not show statistical significance in both groups. CONCLUSIONS: None of the assessed preload indices including PPV were able to predict fluid responsiveness in patients with elevated LV filling pressure.
Authors: Xiaoying Lai; Ping Ouyang; Hong Zhu; Shengli An; Lijuan Xia; Yiting Yao; Han Zhang; Zhi Li; Kan Deng Journal: Nan Fang Yi Ke Da Xue Xue Bao Date: 2020-02-29
Authors: Marc Feissel; Ludwig Serge Aho; Stefan Georgiev; Romain Tapponnier; Julio Badie; Rémi Bruyère; Jean-Pierre Quenot Journal: PLoS One Date: 2015-06-30 Impact factor: 3.240
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