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If you wish to respond to a paper or other item already published in the BJA, please go to the abstract/full text version of that item and click on the link "E-Letters: Submit a response to the article".

Electronic Letters to:

Clinical Practice:
M. Buettner, W. Schummer, E. Huettemann, S. Schenke, N. van Hout, and S. G. Sakka
Influence of systolic-pressure-variation-guided intraoperative fluid management on organ function and oxygen transport
Br. J. Anaesth. 2008; 101: 194-199 [Abstract] [Full text] [PDF]
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Electronic letters published:

[Read E-letter] SPV - Guided fluid management
RESHMA A BHOSALE   (24 October 2008)

SPV - Guided fluid management 24 October 2008
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RESHMA A BHOSALE,
Anaesthetist

Send letter to journal:
Re: SPV - Guided fluid management

Editor - I read the article by M. Buettner and colleagues with interest. This is a topic of constant debate. I was glad to find out about markers of splanchnic perfusion. However, I would like to highlight some aspects of methodology. First, the two groups can not be considered similar if you compare the epidural insertions in each.

Secondly, Table 1 shows that more than 40% of the patients received blood transfusion. There is no data indicating the amount of blood loss. The haemoglobin at its lowest is 8.3 and 8.8 in the SPV(systolic pressure variaion) and control group respectively in Table 2. The criterion stated in the study for RBC transfusion is clinical indication or haematocrit below 23%. Does that mean that there was haemodilution? The average urine output as shown is in excess of 120ml/hr.

In my opinion, with the presented data it is difficult to make a judgment or conclude about use of SPV for fluid management. Yet I do believe that it is a useful and non-invasive guide.

Conflict of Interest:

None declared