Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery.
OBJECTIVE
We hypothesized that measuring stroke volume variation (SVV) during mechanical ventilation by continuous arterial pulse contour analysis allows the accurate prediction and monitoring of changes in cardiac index (CI) in response to volume administration.


METHODS
Prospective study in an university hospital.


METHODS
Twenty mechanically ventilated patients following cardiac surgery.


METHODS
Volume loading with oxypolygelatin (3.5%) 20 ml x body mass index over 10 min.


RESULTS
SVV, central venous pressure (CVP), pulmonary artery occlusion pressure (PAOP), left ventricular end-diastolic area index (LVEDAI) by transesophageal echocardiography, intrathoracic blood volume index (ITBVI) by transpulmonary thermodilution and CI were determined immediately before and after volume loading. SVV decreased, while CI, CVP, PAOP, ITBVI, and LVEDAI increased significantly. Percentage changes in CI were significantly correlated to percentage changes in SVV (r(2)=-0.59, p<0.001), ITBVI (r(2)=0.79, p<0.001), and PAOP (r(2)=0.33, p<0.05) and to baseline values of SVV (r(2)=0.55, p<0.05) and LVEDAI (r(2)=-0.68, p<0.001).


CONCLUSIONS
SVV may help to determine the preload condition of ventilated patients following cardiac surgery and to predict and continuously monitor effects of volume administered as part of their hemodynamic management.
Reuter
Daniel A
DA
Department of Anesthesiology, Grosshadern University Hospital, Ludwig Maximilians University, Marchioninistrasse 15, 81377 Munich, Germany.
Felbinger
Thomas W
TW
Schmidt
Christian
C
Kilger
Erich
E
Goedje
Oliver
O
Lamm
Peter
P
Goetz
Alwin E
AE
D000368:Aged; D000704:Analysis of Variance; D001794:Blood Pressure / Q000502:physiology; D001795:Blood Pressure Determination / Q000379:methods; D001810:Blood Volume / Q000502:physiology*; D006348:Cardiac Surgical Procedures; D005260:Female; D005780:Gelatin / Q000008:administration & dosage; D006801:Humans; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000008:administration & dosage; D011108:Polymers / Q000008:administration & dosage; D011446:Prospective Studies; D012121:Respiration, Artificial; D013318:Stroke Volume / Q000502:physiology*
C115675:Hemaccel; D010952:Plasma Substitutes; D011108:Polymers; D005780:Gelatin