Hypovolaemic hypotension after abdominal aortic surgery is predicted by initial distribution volume of glucose.
OBJECTIVE
Evaluation of volaemia is a crucial question for the management of patients during anaesthesia and in the ICU. Numerous methods have been described, but there is as yet no single ideal parameter. Another way to approach this problem is to predict the extent of hypovolaemia. The initial distribution volume of glucose (IDVG) has been shown to predict the development of hypovolaemic hypotension following oesophageal surgery. In this study, we evaluated the use of the IDVG in predicting hypovolemic hypotension after abdominal aortic surgery.


METHODS
All patients undergoing elective abdominal aortic surgery had IDVG measured following admission to the ICU. Other haemodynamic parameters, such as heart rate, blood pressure, urine output and central venous pressure, were also collected during the first postoperative day. Patients were divided into two groups depending on the occurrence of hypovolaemic hypotension, indicated by a SBP lower than 90 mmHg rapidly corrected by administration of intravenous fluid boluses.


RESULTS
Out of the 27 patients who underwent aortic surgery, 13 developed hypovolaemic hypotension. IDVG was significantly lower in this group when compared with the haemodynamically stable group, that is, 78 (59-122) vs. 120 (63-151) ml kg(-1). This was despite similar haemodynamic parameters between the two groups. The best area under the receiver-operating characteristic curve was obtained for an IDVG value of 91.1 ml kg(-1).


CONCLUSIONS
In this study, IDVG predicts the occurrence of hypovolaemic hypotension after elective abdominal aortic surgery.
Orban
Jean-Christophe
JC
Réanimation Médico-Chirurgicale, Hôpital Saint-Roch, Nice, France. orban.j@chu-nice.fr
Blasin-Chadoutaud
Aurélie
A
Zolfaghari
Parjam
P
Ishihara
Hironori
H
Grimaud
Dominique
D
Ichai
Carole
C
D000368:Aged; D017544:Aortic Aneurysm, Abdominal / Q000601:surgery*; D001786:Blood Glucose / Q000032:analysis*; D006801:Humans; D007022:Hypotension / Q000175:diagnosis* / Q000209:etiology; D020896:Hypovolemia / Q000150:complications / Q000175:diagnosis*; D008875:Middle Aged; D011183:Postoperative Complications / Q000175:diagnosis*; D011237:Predictive Value of Tests; D011446:Prospective Studies; D016037:Single-Blind Method
D001786:Blood Glucose