COMPARATIVE STUDY
JOURNAL ARTICLE

Accuracy of stroke volume variation compared with pleth variability index to predict fluid responsiveness in mechanically ventilated patients undergoing major surgery

Markus Zimmermann, Thomas Feibicke, Cornelius Keyl, Christopher Prasser, Stefan Moritz, Bernhard M Graf, Christoph Wiesenack
European Journal of Anaesthesiology 2010, 27 (6): 555-61
20035228

BACKGROUND AND OBJECTIVE: Accurate assessment of a patient's volume status is an important goal for an anaesthetist. However, most variables assessing fluid responsiveness are either invasive or technically challenging. This study was designed to compare the accuracy of arterial pressure-based stroke volume variation (SVV) and variations in the pulse oximeter plethysmographic waveform amplitude as evaluated with the noninvasive calculated pleth variability index (PVI) with central venous pressure to predict the response of stroke volume index (SVI) to volume replacement in patients undergoing major surgery.

METHODS: We studied 20 patients scheduled for elective major abdominal surgery. After induction of anaesthesia, all haemodynamic variables were recorded immediately before (T1) and subsequent to volume replacement (T2) by infusion of 6% hydroxy-ethyl starch (HES) 130/0.4 (7 ml kg) at a rate of 1 ml kg min.

RESULTS: The volume-induced increase in SVI was at least 15% in 15 patients (responders) and less than 15% in five patients (nonresponders). Baseline SVV correlated significantly with changes in SVI (DeltaSVI; r = 0.80; P < 0.001) as did baseline PVI (r = 0.61; P < 0.004), whereas baseline values of central venous pressure showed no correlation to DeltaSVI. There was no significant difference between the area under the receiver operating characteristic curve for SVV (0.993) and PVI (0.973). The best threshold values to predict fluid responsiveness were more than 11% for SVV and more than 9.5% for PVI.

CONCLUSION: Although arterial pressure-derived SVV revealed the best correlation to volume-induced changes in SVI, the results of our study suggest that both variables, SVV and PVI, can serve as valid indicators of fluid responsiveness in mechanically ventilated patients undergoing major surgery.

Full Text Links

Find Full Text Links for this Article

Discussion

You are not logged in. Sign Up or Log In to join the discussion.

Related Papers

Remove bar
Read by QxMD icon Read
20035228
×

Search Tips

Use Boolean operators: AND/OR

diabetic AND foot
diabetes OR diabetic

Exclude a word using the 'minus' sign

Virchow -triad

Use Parentheses

water AND (cup OR glass)

Add an asterisk (*) at end of a word to include word stems

Neuro* will search for Neurology, Neuroscientist, Neurological, and so on

Use quotes to search for an exact phrase

"primary prevention of cancer"
(heart or cardiac or cardio*) AND arrest -"American Heart Association"