Non-invasive measurements of pulse pressure variation and stroke volume variation in anesthetized patients using the Nexfin blood pressure monitor

Journal of Clinical Monitoring and Computing
Jurre StensChrista Boer

Abstract

Nexfin beat-to-beat arterial blood pressure monitoring enables continuous assessment of hemodynamic indices like cardiac index (CI), pulse pressure variation (PPV) and stroke volume variation (SVV) in the perioperative setting. In this study we investigated whether Nexfin adequately reflects alterations in these hemodynamic parameters during a provoked fluid shift in anesthetized and mechanically ventilated patients. The study included 54 patients undergoing non-thoracic surgery with positive pressure mechanical ventilation. The provoked fluid shift comprised 15° Trendelenburg positioning, and fluid responsiveness was defined as a concomitant increase in stroke volume (SV) >10 %. Nexfin blood pressure measurements were performed during supine steady state, Trendelenburg and supine repositioning. Hemodynamic parameters included arterial blood pressure (MAP), CI, PPV and SVV. Trendelenburg positioning did not affect MAP or CI, but induced a decrease in PPV and SVV by 3.3 ± 2.8 and 3.4 ± 2.7 %, respectively. PPV and SVV returned back to baseline values after repositioning of the patient to baseline. Bland-Altman analysis of SVV and PPV showed a bias of -0.3 ± 3.0 % with limits of agreement ranging from -5.6 to 6.2 %. The SVV was m...Continue Reading

References

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Citations

Oct 6, 2017·Journal of Clinical Monitoring and Computing·Sándor FöldiGyörgy Cserey
Aug 24, 2018·American Journal of Respiratory and Critical Care Medicine·Jean-Louis TeboulFrédéric Michard
Dec 31, 2019·Acta Anaesthesiologica Scandinavica·Akira MukaiKiyonobu Nishikawa
Jan 9, 2017·Journal of Clinical Monitoring and Computing·Bernd SaugelThomas W L Scheeren
Apr 25, 2020·Frontiers in Physiology·Manuel Ignacio Monge GarcíaMichael R Pinsky
Apr 15, 2021·Annals of Intensive Care·Jean-Luc FellahiDan Longrois

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Software Mentioned

SPSS Statistics
Physiocal
Vigileo
Flotrac
Nexfin

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