Comparison between respiratory changes in the inferior vena cava diameter and pulse pressure variation to predict fluid responsiveness in postoperative patients
| Autor: | Renata Teixeira Ladeira, Flávio Geraldo Rezende Freitas, Olivia Haun de Oliveira, Flávia Ribeiro Machado, Claudio Henrique Fischer, Antônio Tonete Bafi, Luciano Cesar Pontes Azevedo |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty Critical Illness Hemodynamics Blood Pressure Vena Cava Inferior Critical Care and Intensive Care Medicine Sensitivity and Specificity Inferior vena cava 03 medical and health sciences 0302 clinical medicine Internal medicine Humans Medicine Cutoff Ventricular outflow tract Postoperative Period Respiratory system Monitoring Physiologic Receiver operating characteristic business.industry Reproducibility of Results 030208 emergency & critical care medicine Middle Aged Confidence interval Pulse pressure ROC Curve 030228 respiratory system medicine.vein Echocardiography Surgical Procedures Operative Anesthesia Cardiology Fluid Therapy Female business |
| Zdroj: | Journal of Critical Care. 34:46-49 |
| ISSN: | 0883-9441 |
| DOI: | 10.1016/j.jcrc.2016.03.017 |
| Popis: | Purpose The objective of our study was to assess the reliability of the distensibility index of the inferior vena cava (dIVC) as a predictor of fluid responsiveness in postoperative, mechanically ventilated patients and compare its accuracy with that of the pulse pressure variation (PPV) measurement. Materials and methods We included postoperative mechanically ventilated and sedated patients who underwent volume expansion with 500mL of crystalloids over 15minutes. A response to fluid infusion was defined as a 15% increase in the left ventricular outflow tract velocity time integral according to transthoracic echocardiography. The inferior vena cava diameters were recorded by a subcostal view using the M-mode and the PPV by automatic calculation. The receiver operating characteristic (ROC) curves were generated for the baseline dIVC and PPV. Results Twenty patients were included. The area under the ROC curve for dIVC was 0.84 (95% confidence interval, 0.63-1.0), and the best cutoff value was 16% (sensitivity, 67%; specificity, 100%). The area under the ROC curve for PPV was 0.92 (95% confidence interval, 0.76-1.0), and the best cutoff was 12.4% (sensitivity, 89%; specificity, 100%). A noninferiority test showed that dIVC cannot replace PPV to predict fluid responsiveness ( P =.28). Conclusion The individual PPV discriminative properties for predicting fluid responsiveness in postoperative patients seemed superior to those of dIVC. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|
Full Text from ScienceDirect