Diagnostic accuracy of stroke volume variation measured with uncalibrated arterial waveform analysis for the prediction of fluid responsiveness in patients with impaired left ventricular function: a prospective, observational study

Autor: L. J. Montenij, E. E. C. de Waal, Wolfgang Buhre, Arno P. Nierich, J. P. C. Sonneveld
Jazyk: angličtina
Rok vydání: 2015
Předmět:
Adult
Male
Cardiac output
medicine.medical_specialty
Observational Study
Health Informatics
Heart failure
030204 cardiovascular system & hematology
Pulse Wave Analysis
Critical Care and Intensive Care Medicine
Pulse wave analysis
03 medical and health sciences
Ventricular Dysfunction
Left
0302 clinical medicine
Positive predicative value
Internal medicine
Dynamic preload
Journal Article
Medicine
Humans
Prospective Studies
Coronary Artery Bypass
Intraoperative monitoring
Original Research
Aged
Aged
80 and over
Ejection fraction
Receiver operating characteristic
business.industry
Area under the curve
030208 emergency & critical care medicine
Stroke Volume
Stroke volume
Middle Aged
medicine.disease
Surgery
Preload
Anesthesiology and Pain Medicine
ROC Curve
Heart Function Tests
Cardiology
Fluid Therapy
Female
business
Cardiac preload
Zdroj: Journal of Clinical Monitoring and Computing
Journal of Clinical Monitoring and Computing, 30(4), 481. Springer Netherlands
ISSN: 1573-2614
1387-1307
Popis: Uncalibrated arterial waveform analysis enables dynamic preload assessment in a minimally invasive fashion. Evidence about the validity of the technique in patients with impaired left ventricular function is scarce, while adequate cardiac preload assessment would be of great value in these patients. The aim of this study was to investigate the diagnostic accuracy of stroke volume variation (SVV) measured with the FloTrac/Vigileo™ system in patients with impaired left ventricular function. In this prospective, observational study, 22 patients with a left ventricular ejection fraction of 40 % or less undergoing elective coronary artery bypass grafting were included. Patients were considered fluid responsive if cardiac output increased with 15 % or more after volume loading (7 ml kg−1 ideal body weight). The following variables were calculated: area under the receiver operating characteristics (ROC) curve, ideal cut-off value for SVV, sensitivity, specificity, positive and negative predictive values, and overall accuracy. In addition, SVV cut-off points to obtain 90 % true positive and 90 % true negative predictions were determined. ROC analysis revealed an area under the curve of 0.70 [0.47; 0.92]. The ideal SVV cut-off value was 10 %, with a corresponding sensitivity and specificity of 56 and 69 % respectively. Overall accuracy was 64 %, positive and negative predictive values were 69 and 56 % respectively. SVV values to obtain more than 90 % true positive and negative predictions were 16 and 6 % respectively. The ability of uncalibrated arterial waveform analysis SVV to predict fluid responsiveness in patients with impaired LVF was low.
Databáze: OpenAIRE
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