Noninvasive pulse pressure variation and stroke volume variation to predict fluid responsiveness at multiple thresholds: a prospective observational study

Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie
Jaap Jan VosAlain F Kalmar

Abstract

Pulse pressure variation (PPV) and stroke volume variation (SVV) are dynamic preload variables that can be measured noninvasively to assess fluid responsiveness (FR) in anesthetized patients with mechanical ventilation. Few studies have examined the effectiveness of predicting FR according to the definition of FR, and assessment of inconclusive values of PPV and SVV around the cut-off value (the "grey zone") might improve individual FR prediction. We explored the ability of noninvasive volume clamp derived measurements of PPV and SVV to predict FR using the grey zone approach, and we assessed the influence of multiple thresholds on the predictive ability of the numerical definition of FR. Ninety patients undergoing general surgery were included in this prospective observational study and received a 500 mL fluid bolus as deemed clinically required by the attending anesthesiologist. A minimal relative increase in stroke volume index (↑SVI) was used to define FR with different thresholds from 10-25%. The PPV, SVV, and SVI were measured using the Nexfin® device that employs noninvasive volume clamp plethysmography. The area under the receiver operator characteristic curve gradually increased for PPV / SVV with higher threshold valu...Continue Reading

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References

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Citations

Aug 25, 2015·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Maxime Cannesson
Aug 18, 2018·Journal of Veterinary Emergency and Critical Care·Behnood GholamiWilliam W Muir
Mar 29, 2019·Canadian Journal of Anaesthesia = Journal Canadien D'anesthésie·Scott J Millington
Apr 23, 2017·Journal of Clinical Monitoring and Computing·Lars Øivind Høiseth, Jostein S Hagemo
Jul 31, 2019·Annals of Medicine and Surgery·Laurence WeinbergChris Christophi
Aug 17, 2021·Anesthesiology Clinics·Ilonka N de Keijzer, Thomas W L Scheeren

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Software Mentioned

ROCR
Physiocal®
R
PASW Statistics
pROC
Nexfin
Excel

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