A mini volume loading test for indication of preoperative dehydration in surgical patients

Andrijauskas, Audrius; Ivaškevičius, Juozas; Porvaneckas, Narūnas; Stankevičius, Edgaras; Svensén, Christer; Uvarovas, Valentinas; Švedienė, Saulė; Kvederas, Giedrius

doi:10.1016/j.medici.2015.02.001

Cited by 5 publications

(13 citation statements)

References 24 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Second, only 71 of 219 patients underwent echocardiographic examination, thus weakening the analysis of the echocardiographic variables. Finally, we did not attempt to identify patients pre‐operatively who might respond to fluid challenges (eg passive leg rising test or a mini‐volume loading test). Instead, we aimed for a fluid management procedure that would be simple to mimic daily practice without the risk of volume overload.…”

Section: Discussionmentioning

confidence: 99%

Pre‐operative fluid bolus for improved haemodynamic stability during minor surgery: A prospectively randomized clinical trial

Kratz

Hinterobermaier

Timmesfeld

et al. 2018

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

Section: Discussionmentioning

confidence: 99%

Pre‐operative fluid bolus for improved haemodynamic stability during minor surgery: A prospectively randomized clinical trial

Kratz

Hinterobermaier

Timmesfeld

et al. 2018

Acta Anaesthesiol Scand

View full text Add to dashboard Cite

show abstract

“…Although the operational conditions of laparoscopic cholecystectomy includes pneumoperitoneum and the reverse Trendelenburg position and both can cause an excessive preload-dependent state, considering laparoscopic cholecystectomy is a less-invasive surgery with minimal bleeding risks, the volume for conventional fluid responsiveness test can be relatively large and may cause a volume overload postoperatively. Although the mini-volume test uses relatively small volumes, it has been used in many previous studies and showed good results [17][18][19].…”

Section: Discussionmentioning

confidence: 99%

Stroke Volume Variation and Stroke Volume Index Can Predict Fluid Responsiveness after Mini-Volume Challenge Test in Patients Undergoing Laparoscopic Cholecystectomy

Moon

Lee

et al. 2019

Medicina

View full text Add to dashboard Cite

Background and Objectives: For using appropriate goal-directed fluid therapy during the surgical conditions of pneumoperitoneum in the reverse Trendelenburg position, we investigated the predictability of various hemodynamic parameters for fluid responsiveness by using a mini-volume challenge test. Materials and Methods: 42 adult patients scheduled for laparoscopic cholecystectomy were enrolled. After general anesthesia was induced, CO2 pneumoperitoneum was applied and the patient was placed in the reverse Trendelenburg position. The mini-volume challenge test was carried out with crystalloid 4 mL/kg over 10 min. Hemodynamic parameters, including stroke volume variation (SVV), cardiac index (CI), stroke volume index (SVI), mean arterial pressure (MAP), and heart rate (HR), were measured before and after the mini-volume challenge test. The positive fluid responsiveness was defined as an increase in stroke volume index ≥10% after the mini-volume challenge. For statistical analysis, a Shapiro–Wilk test was used to test the normality of the data. Continuous variables were compared using an unpaired t-test or the Mann–Whitney rank-sum test. Categorical data were compared using the chi-square test. A receiver operating characteristic curve analysis was used to assess the predictability of fluid responsiveness after the mini-volume challenge. Results: 31 patients were fluid responders. Compared with the MAP and HR, the SVV, CI, and SVI showed good predictability for fluid responsiveness after the mini-volume challenge test (area under the curve was 0.900, 0.833, and 0.909, respectively; all p-values were <0.0001). Conclusions: SVV and SVI effectively predicted fluid responsiveness after the mini-volume challenge test in patients placed under pneumoperitoneum and in the reverse Trendelenburg position.

show abstract

“…We retreived and retrospectively analysed data from our previous randomized controlled trial (Clinicaltrials.Gov, identifier: NCT01355900) in patients who had elective primary total knee arthroplasty (TKA) surgery [2], [7]. The adhesive spectrophotometric sensor (ReSposable R2-25a; Masimo Inc., Irvine, CA) connected to the Radical-7 Pulse CO-Oximeter (Masimo Inc.; software version 7.6.2.1) was used to measure SpHb.…”

Section: Methodsmentioning

confidence: 99%

“…An antecubital cannula for infusion was placed in the same arm. The stepwise infusion was administered according to a revised goal directed therapy (revGDT) protocol consisting of conventional GDT supplemented by the mVLT [2]. The cPDE and acPED were obtained in 48 subjects who had two mVLT sessions -before the induction of anesthesia (preoperative session) and again 24 hours later (post-operative).…”

Section: Methodsmentioning

confidence: 99%

“…Hemoglobin in arteries (invasive, aHb) and capillaries (non-invasive, SpHb) are used to calculate the arterial and capillary plasma dilution efficacies (aPDE and cPDE, respectively) and arteriocapillary plasmadilution efficacy difference (acPED) [1], [3]. Based on observations in healthy volunteers [1] and patients [2], a transcapillary reflux model suggests that acPED ≤ 0 p.d.u. is an indication hemodilution nonresponse and imminent edema.…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Revised Evaluation of Hemodilution Response in the Semi-Closed Loop Infusion System

Markevičius¹,

Činčikas²,

Porvaneckas³

et al. 2016

ElAEE

Self Cite

View full text Add to dashboard Cite

A mini volume loading test (mVLT) method is used for decision making in our prototype semi-closed loop infusion system (SCLIS). The mVLT fluid protocol consists of hemodilution response-guided mini fluid challenges. Each mini fluid challenge (MFC) consists of a 2.5 ml kg-1-5 ml kg-1 crystalloid bolus infused over 2 min-5 min and followed by a 5 min period with no fluids. Arterial plasma dilution efficacy (aPDE) of a MFC is calculated from invasively measured hemoglobin (aHb) before and after each MFC. Capillary plasma dilution efficacy (cPDE) is calculated from noninvasively measured hemoglobin (SpHb). The zero or negative arterio-capillary plasmadilution efficacy difference (acPED ≤ 0 p.d.u.) is an indication of hemodilution non-response and imminent edema. However, it requires both invasive and noninvasive hemoglobin measurements. A non-invasive assessment of hemodilution response within the mVLT method would increase its practical application and reduce costs further enhancing its applicability in the SCLIS. This possibility exists if the cPDE could reliably predict the acPED value or the hemodilution response (the presence of acPED within a range of > 0) or non-response (acPED ≤ 0). We report a retrospective observational study in an elective total knee arthoplasty (TKA) setting. The 2.5 ml kg-1 boluses were used in six MFCs in both pre-and post-operative mVLT sessions. The primary objective was to assess the accuracy of cPDE in predicting the hemodilution response using the receiver operating characteristic (ROC) curve and gray zone approaches. Our secondary objective was to investigate the feasibility of a statistical optimization method (SOM) in predicting the acPED. The analysis included 480 paired values of cPDE and acPED. The best cutoff value for cPDE was 0.015 p.d.u. (specificity = 0.84, sensitivity = 0.90). The gray zone identified a range of cPDE values between 0.013 and 0.028 (p.d.u.) for which the hemodilution response could not be indicated reliably. The 14 % of the cPDE values were in this range.

show abstract

A mini volume loading test for indication of preoperative dehydration in surgical patients

Abstract: Signs of dehydration were observed during mVLT in patients after pre-operative overnight fast. A revised transcapillary reflux model was proposed to explain the results.

Cited by 5 publications

References 24 publications

Pre‐operative fluid bolus for improved haemodynamic stability during minor surgery: A prospectively randomized clinical trial

Pre‐operative fluid bolus for improved haemodynamic stability during minor surgery: A prospectively randomized clinical trial

Stroke Volume Variation and Stroke Volume Index Can Predict Fluid Responsiveness after Mini-Volume Challenge Test in Patients Undergoing Laparoscopic Cholecystectomy

Revised Evaluation of Hemodilution Response in the Semi-Closed Loop Infusion System

Contact Info

Product

Resources

About