Skip Navigation


BJA Advance Access originally published online on July 23, 2009
British Journal of Anaesthesia 2009 103(3):346-351; doi:10.1093/bja/aep200
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow All Versions of this Article:
103/3/346    most recent
aep200v1
Right arrow E-Letters: Submit a response to the article
Right arrow E-letters: View responses
Right arrow Alert me when this article is cited
Right arrow Alert me when E-letters are posted
Right arrow Alert me if a correction is posted
Services
Right arrow Email this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My Personal Archive
Right arrow Download to citation manager
Right arrowRequest Permissions
Right arrow Disclaimer
Google Scholar
Right arrow Articles by Lahner, D.
Right arrow Articles by Hetz, H.
PubMed
Right arrow PubMed Citation
Right arrow Articles by Lahner, D.
Right arrow Articles by Hetz, H.
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us  
What's this?


© The Author [2009]. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournal.org

Evaluation of stroke volume variation obtained by arterial pulse contour analysis to predict fluid responsiveness intraoperatively

D. Lahner1,*, B. Kabon1, C. Marschalek1, A. Chiari1, G. Pestel3, A. Kaider2, E. Fleischmann1 and H. Hetz1

1 Department of Anaesthesiology, General Intensive Care and Pain Control and
2 Core Unit for Medical Statistics and Informatics, Section of Clinical, Biometrics, Medical University of Vienna, Waehringerguertel 18-20, 1090 Vienna, Austria
3 Department of Anaesthesiology, Johannes Gutenberg University, Langenbeckstrasse 1, 55131 Mainz, Germany

* Corresponding author. E-mail: daniel.lahner{at}meduniwien.ac.at

Background: Fluid management guided by oesophageal Doppler monitor has been reported to improve perioperative outcome. Stroke volume variation (SVV) is considered a reliable clinical predictor of fluid responsiveness. Consequently, the aim of the present trial was to evaluate the accuracy of SVV determined by arterial pulse contour (APCO) analysis, using the FloTracTM/VigileoTM system, to predict fluid responsiveness as measured by the oesophageal Doppler.

Methods: Patients undergoing major abdominal surgery received intraoperative fluid management guided by oesophageal Doppler monitoring. Fluid boluses of 250 ml each were administered in case of a decrease in corrected flow time (FTc) to <350 ms. Patients were connected to a monitoring device, obtaining SVV by APCO. Haemodynamic variables were recorded before and after fluid bolus application. Fluid responsiveness was defined as an increase in stroke volume index >10%. The ability of SVV to predict fluid responsiveness was assessed by calculation of the area under the receiver operating characteristic (ROC) curve.

Results: Twenty patients received 67 fluid boluses. Fifty-two of the 67 fluid boluses administered resulted in fluid responsiveness. SVV achieved an area under the ROC curve of 0.512 [confidence interval (CI) 0.32–0.70]. A cut-off point for fluid responsiveness was found for SVV ≥8.5% (sensitivity: 77%; specificity: 43%; positive predictive value: 84%; and negative predictive value: 33%).

Conclusions: This prospective, interventional observer-blinded study demonstrates that SVV obtained by APCO, using the FloTracTM/VigileoTM system, is not a reliable predictor of fluid responsiveness in the setting of major abdominal surgery.

Keywords: fluid balance; measurement techniques, cardiac output; monitoring, arterial pressure; monitoring, cardiopulmonary


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us    What's this?


This article has been cited by other articles:


Home page
 Br J AnaesthHome page
M. Cannesson, B. Vallet, F. Michard, D. Lahner, E. Fleischmann, H. Hetz, G. Pestel, G. Gouvea, R. Diaz, L. Auler, et al.
Pulse pressure variation and stroke volume variation: from flying blind to flying right?
Br. J. Anaesth., December 1, 2009; 103(6): 896 - 899.
[Full Text] [PDF]

E-letters:

Read all E-letters

Pulse Pressure Variation and Stroke Volume Variation: from Flying Blind to Flying Right?
Maxime Cannesson, et al.
British Journal of Anaesthesia, 1 Sep 2009 [Full text]
Re: Pulse Pressure Variation and Stroke Volume Variation: from Flying Blind to Flying Right?
Glauber Gouvêa
British Journal of Anaesthesia, 21 Sep 2009 [Full text]
From the quest for the ‘holy grail’ of fluid responsiveness
Daniel Lahner, et al.
British Journal of Anaesthesia, 21 Sep 2009 [Full text]

Disclaimer: Please note that abstracts for content published before 1996 were created through digital scanning and may therefore not exactly replicate the text of the original print issues. All efforts have been made to ensure accuracy, but the Publisher will not be held responsible for any remaining inaccuracies. If you require any further clarification, please contact our Customer Services Department.