title: Prediction of fluid responsiveness in septic shock patients:  comparing stroke volume variation by FloTrac/Vigileo and automated pulse pressure variation.
abstract: OBJECTIVE
  The aim of this study was to assess and compare the ability of the automatically and continuously measured stroke volume variation (SVV) obtained by FloTrac/Vigileo, and pulse pressure variation (PPV) measured by an IntelliVue MP monitor, to predict fluid responsiveness in mechanically ventilated septic shock patients.
  
  
  METHODS
  We conducted a prospective study on 42 septic shock patients. SVV, PPV and other haemodynamic data were recorded before and after fluid administration of 500 ml of 6% hydroxyethyl starch. Responders were defined as patients with an increase in stroke volume index of at least 15% after fluid loading.
  
  
  RESULTS
  Twenty-four (57.1%) patients were classified as fluid responders. The baseline SVV correlated with the baseline PPV (r=0.96, P<0.001). SVV and PPV were significantly higher in responders than in nonresponders (15.5±4.5 vs. 8.2±3.3% and 16.4±5.2 vs. 8.3±3.5, respectively, P<0.001 for both). There was no difference between the area under the receiver operating characteristic curves of SVV [0.92, 95% confidence interval 0.832-1.00] and PPV (0.916, 95% confidence interval 0.829-1.00). The optimal threshold values in predicting fluid responsiveness were 10% for SVV (sensitivity 91.7% and specificity 83.3%) and 12% for PPV (sensitivity 83.3% and specificity 83.3%). Our results were independent of the site of arterial catheterisation.
  
  
  CONCLUSIONS
  The SVV, obtained by FloTrac/Vigileo, and the automated PPV, obtained by the IntelliVue MP monitor, showed comparable performance in terms of predicting fluid responsiveness in passively ventilated septic shock patients, with a regular cardiac rhythm and a tidal volume not less than 8 ml kg(-1).
authors.affiliation: Division of Critical Care Medicine, Department of Internal Medicine, Faculty of Medicine, Prince of Songkla University, Hat Yai, Songkhla, Thailand. kbordin@medicine.psu.ac.th
authors.forename: Bodin
authors.initials: B
authors.lastname: Khwannimit
authors.forename: Rungsun
authors.initials: R
authors.lastname: Bhurayanontachai
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D005260:Female; D005440:Fluid Therapy / Q000379:methods*; D006801:Humans; D006895:Hydroxyethyl Starch Derivatives / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010952:Plasma Substitutes / Q000008:administration & dosage*; D011446:Prospective Studies; D012372:ROC Curve; D012121:Respiration, Artificial / Q000379:methods; D012680:Sensitivity and Specificity; D012772:Shock, Septic / Q000628:therapy*; D013318:Stroke Volume; D016896:Treatment Outcome
chemical_list: D006895:Hydroxyethyl Starch Derivatives; D010952:Plasma Substitutes