Comparative study of pressure- and volume-controlled ventilation on stroke volume variation as a predictor of fluid responsiveness in patients undergoing major abdominal surgery.
OBJECTIVE
We hypothesized that the 2 ventilation modes might have a different influence on the stroke volume variation (SVV). This study investigated the effect of the ventilation modes on SVV as a predictor of fluid responsiveness during major abdominal surgery.


METHODS
Sixty patients were randomly allocated to volume-controlled ventilation (VCV, n = 30) or pressure-controlled ventilation (PCV, n = 30) modes. After the induction of anesthesia, hemodynamic variables and SVV were measured before and after volume expansion (VE) with colloid solution of 10 mL/kg. The ability of SVV to predict the fluid responsiveness was tested by calculation of the area under a receiver operating characteristic curve for an increase in stroke volume index of at least 15% after VE.


RESULTS
There were 10 and 16 responders in the VCV and PCV groups, respectively. The area under a receiver operating characteristic curve (95% confidence interval) for SVV before VE was 0.723 (0.538-0.907) and 0.799 (0.625-0.973) in the VCV and PCV groups, respectively. The optimal threshold value of SVV was 11% and 14% in the VCV and PCV groups, respectively.


CONCLUSIONS
Stroke volume variation can predict fluid responsiveness during both VCV and PCV modes. However, the optimal threshold values of SVV may differ according to the ventilation modes.
Department of Anesthesiology and Pain Medicine, Gachon University of Medicine and Science, Gil Medical Center, Incheon 405-760, Korea.
Ji Yeon
JY
Lee
Hee Yeon
HY
Park
Wol Seon
WS
Jung
Youn Yi
YY
Jo
Hyun Jeong
HJ
Kwak
D000005:Abdomen / Q000601:surgery*; D000368:Aged; D003102:Colloids / Q000627:therapeutic use; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve; D012121:Respiration, Artificial / Q000379:methods*; D013318:Stroke Volume / Q000502:physiology*
D003102:Colloids