The impact of intra-abdominal pressure on the stroke volume variation and plethysmographic variability index in patients undergoing laparoscopic cholecystectomy

Liu, Fangfang; Zhu, Shirley; Ji, Qing; Li, Weiyan; Liu, Jian

doi:10.5582/bst.2015.01029

Cited by 15 publications

(15 citation statements)

References 19 publications

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“…It is important for clinicians to note that there is a sustained increase in mean arterial pressure with insufflation. Hence, while the shifts in blood volume (between stressed and unstressed compartments) are transient, the increased afterload (hypertension) is sustained (Joris et al 1993 ; Alfonsi et al 2006 ; Liu et al 2015 ).…”

Section: Resultsmentioning

confidence: 99%

“…Insufflation increases the absolute value of measures such as stroke volume variation and plethysmography (Liu et al 2015 ), meeting the threshold defining of “fluid responsiveness.” This does not imply that fluid therapy is needed (as discussed in question iv above) (Guinot et al 2014 ). Clinicians should anticipate increases in blood pressure with minimal overall sustained changes in cardiac output (with insufflation to 14 mmHg or less).…”

Section: Resultsmentioning

confidence: 99%

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American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery

et al. 2016

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BackgroundEnhanced recovery may be viewed as a comprehensive approach to improving meaningful outcomes in patients undergoing major surgery. Evidence to support enhanced recovery pathways (ERPs) is strong in patients undergoing colorectal surgery. There is some controversy about the adoption of specific elements in enhanced recovery “bundles” because the relative importance of different components of ERPs is hard to discern (a consequence of multiple simultaneous changes in clinical practice when ERPs are initiated). There is evidence that specific approaches to fluid management are better than alternatives in patients undergoing colorectal surgery; however, several specific questions remain.MethodsIn the “Perioperative Quality Initiative (POQI) Fluids” workgroup, we developed a framework broadly applicable to the perioperative management of intravenous fluid therapy in patients undergoing elective colorectal surgery within an ERP.DiscussionWe discussed aspects of ERPs that impact fluid management and made recommendations or suggestions on topics such as bowel preparation; preoperative oral hydration; intraoperative fluid therapy with and without devices for goal-directed fluid therapy; and type of fluid.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery

et al. 2016

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“…Moreover, we used pre‐defined target values of haemodynamic indices, and it might be questioned whether these target values can be applied to all patients for moderate‐risk abdominal surgery or whether different values should have been applied for laparoscopic and open surgical procedures. Although PPV is considered to be unaffected by pneumoperitoneum in rabbits , SVV may be affected by increasing intra‐abdominal pressure in a laparoscopic cholecystectomy setting . Renner et al.…”

Section: Discussionmentioning

confidence: 99%

The added value of cardiac index and pulse pressure variation monitoring to mean arterial pressure-guided volume therapy in moderate-risk abdominal surgery (COGUIDE): a pragmatic multicentre randomised controlled trial

et al. 2017

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There is disagreement regarding the benefits of goal-directed therapy in moderate-risk abdominal surgery. Therefore, we tested the hypothesis that the addition of non-invasive cardiac index and pulse pressure variation monitoring to mean arterial pressure-based goal-directed therapy would reduce the incidence of postoperative complications in patients having moderate-risk abdominal surgery. In this pragmatic multicentre randomised controlled trial, we randomly allocated 244 patients by envelope drawing in a 1:1 fashion, stratified per centre. All patients had mean arterial pressure, cardiac index and pulse pressure variation measured continuously. In one group, healthcare professionals were blinded to cardiac index and pulse pressure variation values and were asked to guide haemodynamic therapy only based on mean arterial pressure (control group). In the second group, cardiac index and pulse pressure variation values were displayed and kept within target ranges following a pre-defined algorithm (CI-PPV group). The primary endpoint was the incidence of postoperative complications within 30 days. One hundred and seventy-five patients were eligible for final analysis. Overall complication rates were similar (42/94 (44.7%) vs. 38/81 (46.9%) in the control and CI-PPV groups, respectively; p = 0.95). The CI-PPV group had lower mean (SD) pulse pressure variation values (9.5 (2.0)% vs. 11.9 (4.6)%; p = 0.003) and higher mean (SD) cardiac indices (2.76 (0.62) l min .m vs. 2.53 (0.66) l min .m ; p = 0.004) than the control group. In moderate-risk abdominal surgery, we observed no additional value of cardiac index and pulse pressure variation-guided haemodynamic therapy to mean arterial pressure-guided volume therapy with regard to postoperative complications.

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“…Dynamic indices such as stroke volume variation (SVV), pulse pressure variation, and systolic pressure variation have consistently been shown to be more accurate than static indicators such as central venous pressure (CVP) and pulmonary capillary wedge pressure for predicting fluid responsiveness in mechanically ventilated patients under general anesthesia (1)(2)(3)(4). The accurate assessment of intravascular fluid status and measurement of fluid responsiveness have become increasingly important in peri-operative medicine and critical care (4).…”

Section: Introductionmentioning

confidence: 99%

Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia?

Wajima

Shiga

Imanaga

2017

BST

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The impact of intra-abdominal pressure on the stroke volume variation and plethysmographic variability index in patients undergoing laparoscopic cholecystectomy

Cited by 15 publications

References 19 publications

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery

American Society for Enhanced Recovery (ASER) and Perioperative Quality Initiative (POQI) joint consensus statement on perioperative fluid management within an enhanced recovery pathway for colorectal surgery

The added value of cardiac index and pulse pressure variation monitoring to mean arterial pressure-guided volume therapy in moderate-risk abdominal surgery (COGUIDE): a pragmatic multicentre randomised controlled trial

Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia?

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