Comparison of stroke volume variations derived from radial and femoral arterial pressure waveforms during liver transplantation.
BACKGROUND
Stroke volume variation (SVV) is being increasingly used to predict fluid responsiveness. Since radial arterial pressure (RAP) and femoral arterial pressure (FAP) frequently showing discrepancies during liver transplantation (LT), we sought to investigate the effect of differing arterial waveforms on SVV and cardiac output (CO) derived from the Vigileo device, by comparing SVV and CO values derived from RAP (SVV(RAP), CO(RAP)) and FAP (SVV(FAP), CO(FAP)) during LT.


METHODS
The linear associations and agreements between SVV(RAP) and SVV(FAP) and between CO(RAP) and CO(FAP) were assessed during LT. Hemodynamic variables were measured at nine predefined time points in all 32 recipients, resulting in 288 data pairs.


RESULTS
Correlations were observed between SVV(RAP) and SVV(FAP) (r = .961) and between CO(RAP) and CO(FAP) (r = .848) at all time points. These correlations between SVV(RAP) and SVV(FAP) (r = .923) and between CO(RAP) and CO(FAP) (r = .902) existed even during the period when mean RAP and FAP values differed (10 minutes after reperfusion). Bland-Altman analysis for SVV(RAP) versus SVV(FAP) and for CO(RAP) versus CO(FAP) showed weak biases (-0.2% and -0.5 L/min) and reasonable limits of agreement (-2.2 to 1.8% and -1.9 to 0.9 L/min). The percentage errors for SVV and CO values were 27.0% and 22.2%.


CONCLUSIONS
There was no significant difference between SVV(RAP) and SVV(FAP) when measured using the Vigileo device during LT. This finding indicated that SVV obtained using the Vigileo device offered relatively consistent information regardless of the catheterization site.
Kim
Y K
YK
Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap 2dong, Song pa-gu, Seoul 138-736, South Korea. kshwang@amc.seoul.kr
Shin
W J
WJ
Song
J G
JG
Jun
I G
IG
Kim
H Y
HY
Seong
S H
SH
Hwang
G S
GS
D000328:Adult; D001794:Blood Pressure / Q000502:physiology; D001827:Body Height; D001835:Body Weight; D002302:Cardiac Output / Q000502:physiology*; D005260:Female; D005263:Femoral Artery / Q000503:physiopathology*; D006339:Heart Rate / Q000502:physiology; D006801:Humans; D017114:Liver Failure, Acute / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation / Q000502:physiology*; D019520:Living Donors; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000379:methods*; D017534:Radial Artery / Q000503:physiopathology*; D013318:Stroke Volume / Q000502:physiology*