title: Hemodynamic changes during a deep inspiration maneuver predict fluid responsiveness in spontaneously breathing patients.
abstract: OBJECTIVE
  We hypothesized that the hemodynamic response to a deep inspiration maneuver (DIM) indicates fluid responsiveness in spontaneously breathing (SB) patients.
  
  
  METHODS
  Prospective study.
  
  
  METHODS
  ICU of a general hospital.
  
  
  METHODS
  Consecutive nonintubated patients without mechanical ventilation, considered for volume expansion (VE).
  
  
  METHODS
  We assessed hemodynamic status at baseline and after VE.
  
  
  RESULTS
  We measured radial pulse pressure (PP) using an arterial catheter and peak velocity of femoral artery flow (VF) using continuous Doppler. Changes in PP and VF induced by a DIM (ΔPPdim and ΔVFdim) were calculated in 23 patients. ΔPPdim and ΔVFdim ≥12% predicted responders to VE with sensitivity of 90% and specificity of 100%.
  
  
  CONCLUSIONS
  In a restricted population of SB patients with severe sepsis or acute pancreatitis, ΔPPdim and ΔVFdim are accurate indices for predicting fluid responsiveness. These results should be confirmed in a larger population before validating their use in current practice.
authors.affiliation: Service de Réanimation Polyvalente, Centre Hospitalier Jean Bernard, Avenue Désandrouin, 59300 Valenciennes, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Préau
authors.forename: Florent
authors.initials: F
authors.lastname: Dewavrin
authors.forename: Vincent
authors.initials: V
authors.lastname: Soland
authors.forename: Perrine
authors.initials: P
authors.lastname: Bortolotti
authors.forename: Delphine
authors.initials: D
authors.lastname: Colling
authors.forename: Jean-Luc
authors.initials: JL
authors.lastname: Chagnon
authors.forename: Alain
authors.initials: A
authors.lastname: Durocher
authors.forename: Fabienne
authors.initials: F
authors.lastname: Saulnier