Stroke volume variation compared with pulse pressure variation and cardiac index changes for prediction of fluid responsiveness in mechanically ventilated patients

Soliman, Randa Aly; Samir, Shereif; Naggar, Ahmed El; Dehely, Khalaf El

doi:10.1016/j.ejccm.2015.02.002

Cited by 6 publications

(6 citation statements)

References 21 publications

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“…This study, to our knowledge, is first ever Indian study to undertake a head-to-head comparison of three arterial waveform-derived variables in their ability to predict responsiveness to fluid bolus in critically ill hemodynamically unstable patients. It is different from previous studies in that instead of administering an arbitrary volume of fluid, irrespective of weight, as boluses, ranging from 500 mL to 1000 mL, 13 , 16 – 18 we calculated the volume of fluid given as challenge on the basis of body weight (10 mL/kg). Also, we collected data at 60 minutes, unlike previous studies, and so our study is better poised to evaluate the duration of effects of fluid challenge.…”

Section: Discussionmentioning

confidence: 99%

“…The mean threshold value was 11.6 ± 1.9% for the SVV in responders, which was similar to our findings, 15 whereas it showed that baseline SVV >8.15% predicted fluid responsiveness in mechanically ventilated patients with acute circulatory failure. 13 In contrast, older studies failed to appreciate the ability of SVV to predict fluid responsiveness. 19 , 20 This could probably be explained by the fact that they used the first software version (1.01) of Vigileo-FloTrac, which has a recalibration interval of 10 minutes.…”

Section: Discussionmentioning

confidence: 99%

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Comparison of the Efficacy of Different Arterial Waveform-derived Variables (Pulse Pressure Variation, Stroke Volume Variation, Systolic Pressure Variation) for Fluid Responsiveness in Hemodynamically Unstable Mechanically Ventilated Critically Ill Patients

Kumar

Malviya

Nath

et al. 2021

Indian Journal of Critical Care Medicine

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A bstract Introduction This study was conducted to assess fluid responsiveness in critically ill patients to avoid various complications of fluid overload. Material and methods This study was done in an ICU of a tertiary care hospital after approval from the institute ethical committee over 18 months. A total of 54 consenting adult patients were included in the study. Patients were hemodynamically unstable requiring mechanical ventilation, had acute circulatory failure, or those with at least one clinical sign of inadequate tissue perfusion. All patients were ventilated using tidal volume of 6–8 mL/kg, RR—12–15/minutes, positive end expiratory pressure (PEEP)—5 cm of water, and plateau pressure was kept below 30 cm water. They were sedated throughout the study. The arterial line and the central venous catheter were placed and connected to Vigileo-FloTrac transducer (Edward Lifesciences). Patients were classified into responder and nonresponder groups on the basis of the cardiac index (CI) after fluid challenge of 10 mL/kg of normal saline over 30 minutes. Pulse pressure variation (PPV), stroke volume variation (SVV), and systolic pressure variation (SPV) were assessed and compared at baseline, 30 minutes, and 60 minutes. Results In our study we found that PPV and SVV were significantly lower among responders than nonresponders at 30 minutes and insignificant at 60 minutes. Stroke volume variation was 10.28 ± 1.76 in the responder compared to 12.28 ± 4.42 ( p = 0.02) at 30 minutes and PPV was 15.28 ± 6.94 in responders while it was 20.03 ± 4.35 in nonresponders ( p = 0.01). We found SPV was insignificant at all time periods among both groups. Conclusion We can conclude that initial assessment for fluid responsiveness in critically ill mechanically ventilated patients should be based on PPV and SVV to prevent complications of fluid overload and their consequences. How to cite this article Kumar N, Malviya D, Nath SS, Rastogi S, Upadhyay V. Comparison of the Efficacy of Different Arterial Waveform-derived Variables (Pulse Pressure Variation, Stroke Volume Variation, Systolic Pressure Variation) for Fluid Responsiveness in Hemodynamically Unstable Mechanically Ventilated Critically Ill Patients. Indian J Crit Care Med 2021;25(1):48–53.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Comparison of the Efficacy of Different Arterial Waveform-derived Variables (Pulse Pressure Variation, Stroke Volume Variation, Systolic Pressure Variation) for Fluid Responsiveness in Hemodynamically Unstable Mechanically Ventilated Critically Ill Patients

Kumar

Malviya

Nath

et al. 2021

Indian Journal of Critical Care Medicine

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“…5 Por lo tanto, las primeras preguntas que los médicos deben hacerse son: 1) si el problema clínico en cuestión puede resolverse (parcialmente) aumentando el gasto cardiaco y 2) si la reanimación con líquidos será eficaz para lograr este objetivo. [6][7][8][9][10] La variabilidad de volumen sistólico (VVS) se define como el promedio entre el máximo y el mínimo volumen sistólico registrados durante tres ciclos respiratorios. En VVS se evalúa la respuesta al volumen mediante cambios de volumen, no de presión, con parámetros de ventilación estándar para poder ser fidedigno el cambio en este caso de porcentaje evaluado con un punto de corte 13%, siendo respondedor a volumen con un valor por debajo de dicho número.…”

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Correlación entre la integral velocidad tiempo (IVT) del tracto de salida del ventrículo izquierdo (TSVI) y variabilidad de volumen sistólico (VVS) como predictores respondedores a volumen en pacientes con choque en la Unidad de Cuidados Intensivos

Guerrero¹,

Medellín²

2023

Medicina Crítica

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Correlación entre la integral velocidad tiempo (IVT) del tracto de salida del ventrículo izquierdo (TSVI) y variabilidad de volumen sistólico (VVS) como predictores respondedores a volumen en pacientes con choque en la Unidad de Cuidados Intensivos Correlation between velocity time integral (VTI) of the left ventricular outflow tract (LVOT) and systolic volume variability (SVV) as predictors of volume responders in patients with shock in the Intensive Care Unit Correlação entre a integral velocidade-tempo (IVT) da via de saída do ventrículo esquerdo (VSVI) e a variabilidade do volume sistórico (VVS) como preditores de volume respondedor em pacientes com choque na Unidade de Terapia Intensiva

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“…The first method developed to assess dynamic preload responsiveness was stroke volume variability (SVV), it was in 2000 where PPV was shown to predict the response of cardiac output to fluids. 19 And to date, it has the most number of accumulated evidence. 6,20 The median threshold of the PPV used in several studies was 12% (interquartile range 10-13%).…”

Section: Effect Of High Ppv and Decrease In Ppvmentioning

confidence: 99%

Prediction of fluid responsiveness in the immediate post-operative period of cardiac surgery

Albano¹,

Habana²

2021

JACCOA

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Background: Prediction of fluid responsiveness can identify patients who will benefit from fluid loading in the immediate postoperative period of cardiac surgery. Several hemodynamic parameters may help identify those who will benefit from hydration. This study aimed to identify and compare the parameters that predict fluid responsiveness in post-cardiac surgery patients. Methodology: This prospective cohort study included 101 post-cardiac surgery patients. Hemodynamic parameters were recorded at baseline and after an 8 mL/kg IV fluid challenge. Fluid responders are those with an increase in stroke volume of ≥15%. Multivariate analysis was used to identify independent predictors of fluid responder status. Sensitivity and specificity analyses were done to determine the predictive accuracy of each parameter. Results: The rate of fluid responsiveness was 54.5%. Independent predictors were: central venous pressure (CVP) ≤6 mmHg (p=0.001), pulmonary artery occlusion pressure (PAOP) ≤12 mmHg (p=0.016), PAOP increase by ≥7 mmHg (p=0.002), pulse pressure variability (PPV) >12% (p<0.001), PPV decrease by >5% (p=0.049) and weight (p=0.04). PPV was the most sensitive (92%) and specific (74%); while PAOP was the least sensitive (70%) and CVP the least specific (51%). PPV had the highest ability to discriminate fluid responders (AUC 0.83) compared to PAOP (AUC 0.21) and CVP (AUC 0.40) (p<0.0001). Conclusion: PPV (a dynamic index) is superior to CVP and PAOP (static indices) in discriminating fluid responders in adult patients who underwent cardiac surgery. PPV is the favored tool to guide initiation of fluid therapy in this clinical setting.

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Stroke volume variation compared with pulse pressure variation and cardiac index changes for prediction of fluid responsiveness in mechanically ventilated patients

Cited by 6 publications

References 21 publications

Comparison of the Efficacy of Different Arterial Waveform-derived Variables (Pulse Pressure Variation, Stroke Volume Variation, Systolic Pressure Variation) for Fluid Responsiveness in Hemodynamically Unstable Mechanically Ventilated Critically Ill Patients

Comparison of the Efficacy of Different Arterial Waveform-derived Variables (Pulse Pressure Variation, Stroke Volume Variation, Systolic Pressure Variation) for Fluid Responsiveness in Hemodynamically Unstable Mechanically Ventilated Critically Ill Patients

Correlación entre la integral velocidad tiempo (IVT) del tracto de salida del ventrículo izquierdo (TSVI) y variabilidad de volumen sistólico (VVS) como predictores respondedores a volumen en pacientes con choque en la Unidad de Cuidados Intensivos

Prediction of fluid responsiveness in the immediate post-operative period of cardiac surgery

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