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Stroke Volume Variation and Pulse Pressure Variation Are Not Useful for Predicting Fluid Responsiveness in Thoracic Surgery
- Source :
- Anesthesia and analgesia. 125(4)
- Publication Year :
- 2017
-
Abstract
- Stroke volume variation (SVV) and pulse pressure variation (PPV) are used as indicators of fluid responsiveness, but little is known about the usefulness of these dynamic preload indicators in thoracic surgery, which involves an open thoracic cavity and 1-lung ventilation (OLV). Therefore, we investigated whether SVV and PPV could predict fluid responsiveness, and whether the thresholds of these parameters should be adjusted for thoracic surgery.This was a prospective, controlled study conducted in a tertiary care center. Eighty patients scheduled for an elective lobectomy requiring OLV were included (n = 40, video-assisted thoracoscopic surgery (VATS); n = 40, open thoracotomy). Twenty minutes after opening the thoracic cavity, 7 mL/kg hydroxyethyl starch was administered for 30 minutes. Various hemodynamic parameters were measured before and after fluid challenge.Among the 80 patients enrolled in this study, 37% were fluid responders (increase in stroke volume index ≥10%). SVV before fluid challenge was not different between nonresponders and responders (mean ± SD: 7.1 ± 2.7% vs 7.4 ± 2.6%, P = .68). This finding was true regardless of whether the surgery involved open thoracotomy or VATS. PPV before fluid challenge showed the difference between nonresponders and responders (mean ± SD: 6.9 ± 3.0% vs 8.4 ± 3.2%; P = .045); however, the sensitivity and specificity of the threshold value (PPV = 7%) were low (58% and 62%, respectively) and the area under the receiver operating characteristics curve was only 0.63 (95% confidence interval, 0.52-0.74; P = .041).Dynamic preload indicators are not useful for predicting fluid responsiveness in VATS or open thoracic surgery.
- Subjects :
- Male
medicine.medical_specialty
Fluid responsiveness
Blood Pressure
03 medical and health sciences
0302 clinical medicine
030202 anesthesiology
Predictive Value of Tests
Medicine
Humans
Prospective Studies
Aged
business.industry
Thoracic cavity
Thoracic Surgery, Video-Assisted
030208 emergency & critical care medicine
Stroke Volume
Stroke volume
Middle Aged
Thoracic Surgical Procedures
Pulse pressure
Preload
Anesthesiology and Pain Medicine
medicine.anatomical_structure
Cardiothoracic surgery
Elective Surgical Procedures
Anesthesia
Breathing
Fluid Therapy
Female
business
Subjects
Details
- ISSN :
- 15267598
- Volume :
- 125
- Issue :
- 4
- Database :
- OpenAIRE
- Journal :
- Anesthesia and analgesia
- Accession number :
- edsair.doi.dedup.....8be68fffc45bbce15f4b55e7e9392a3c