Comparison of the Efficacy of Different Arterial Waveform-derived Variables (Pulse Pressure Variation, Stroke Volume Variation, Systolic Pressure Variation) for Fluid Responsiveness in Hemodynamically Unstable Mechanically Ventilated Critically Ill Patients
| Autor: | Shivani Rastogi, Soumya Sankar Nath, Vishal Upadhyay, Nitish Kumar, Deepak Malviya |
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| Jazyk: | angličtina |
| Rok vydání: | 2021 |
| Předmět: |
Mechanical ventilation
medicine.medical_specialty business.industry medicine.medical_treatment Pulse pressure variation Cardiac index Stroke volume Critical Care and Intensive Care Medicine Positive end expiratory pressure Pulse pressure Plateau pressure Blood pressure Stroke volume variation Internal medicine Cardiology medicine Arterial line business Tidal volume Positive end-expiratory pressure Research Article Systolic pressure variation |
| Zdroj: | Indian Journal of Critical Care Medicine : Peer-reviewed, Official Publication of Indian Society of Critical Care Medicine |
| ISSN: | 1998-359X 0972-5229 |
| Popis: | Introduction This study was conducted to assess fluid responsiveness in critically ill patients to avoid various complications of fluid overload. Material and methods This study was done in an ICU of a tertiary care hospital after approval from the institute ethical committee over 18 months. A total of 54 consenting adult patients were included in the study. Patients were hemodynamically unstable requiring mechanical ventilation, had acute circulatory failure, or those with at least one clinical sign of inadequate tissue perfusion. All patients were ventilated using tidal volume of 6-8 mL/kg, RR-12-15/minutes, positive end expiratory pressure (PEEP)-5 cm of water, and plateau pressure was kept below 30 cm water. They were sedated throughout the study. The arterial line and the central venous catheter were placed and connected to Vigileo-FloTrac transducer (Edward Lifesciences). Patients were classified into responder and nonresponder groups on the basis of the cardiac index (CI) after fluid challenge of 10 mL/kg of normal saline over 30 minutes. Pulse pressure variation (PPV), stroke volume variation (SVV), and systolic pressure variation (SPV) were assessed and compared at baseline, 30 minutes, and 60 minutes. Results In our study we found that PPV and SVV were significantly lower among responders than nonresponders at 30 minutes and insignificant at 60 minutes. Stroke volume variation was 10.28 ± 1.76 in the responder compared to 12.28 ± 4.42 (p = 0.02) at 30 minutes and PPV was 15.28 ± 6.94 in responders while it was 20.03 ± 4.35 in nonresponders (p = 0.01). We found SPV was insignificant at all time periods among both groups. Conclusion We can conclude that initial assessment for fluid responsiveness in critically ill mechanically ventilated patients should be based on PPV and SVV to prevent complications of fluid overload and their consequences. How to cite this article Kumar N, Malviya D, Nath SS, Rastogi S, Upadhyay V. Comparison of the Efficacy of Different Arterial Waveform-derived Variables (Pulse Pressure Variation, Stroke Volume Variation, Systolic Pressure Variation) for Fluid Responsiveness in Hemodynamically Unstable Mechanically Ventilated Critically Ill Patients. Indian J Crit Care Med 2021;25(1):48-53. |
| Databáze: | OpenAIRE |
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