title: Stroke volume variation derived by arterial pulse contour analysis is a good indicator for preload estimation during liver transplantation.
abstract: BACKGROUND
  Accurate determination of preload during liver transplantation is essential. Continuous right ventricular end diastolic volume index (RVEDVI) has been shown to be a better preload indicator during liver transplantation than the filling pressures. However, recent evidence has shown that dynamic variables, in this case stroke volume variation (SVV), are also good indicators of preload responsiveness. In this study, we evaluated the correlation between SVV, which we derived from arterial pulse contour analysis and RVEDVI.
  
  
  METHODS
  In this study, we looked for possible relationships between SVV obtained through FloTrac/Vigileo monitor, central venous pressure (CVP), pulmonary arterial occlusion pressure (PAOP), and RVEDVI in 30 patients undergoing liver transplantation. Measurements were taken at 11 defined points during different phases across liver transplantation. Each set of measurement was taken during a steady state, which means at least 15 minutes elpased after any changes occured in either the infusion rate of catecholamines or ventilator settings. Pearson's test was used for correlation estimation.
  
  
  RESULTS
  There was a statistically significant (P<.01) relationship between SVV and RVEDVI with a correlation coefficient of -0.87. The correlations between CVP (r=0.42), PAOA (r=0.46), and RVEDVI were less strong.
  
  
  CONCLUSIONS
  We conclude that SVV is a good indicator for preload estimation during liver transplantation. A higher SVV value is associated with a more hypovolemic fluid status.
authors.affiliation: Department of Anesthesia, Chang Gung Memorial Hospital-Linkou, and College of Medicine, Chang Gung University, Kwei-Shan Taoyuan, Taiwan, People's Republic of China.
authors.forename: B C
authors.initials: BC
authors.lastname: Su
authors.forename: Y F
authors.initials: YF
authors.lastname: Tsai
authors.forename: C W
authors.initials: CW
authors.lastname: Cheng
authors.forename: H P
authors.initials: HP
authors.lastname: Yu
authors.forename: M W
authors.initials: MW
authors.lastname: Yang
authors.forename: W C
authors.initials: WC
authors.lastname: Lee
authors.forename: C C
authors.initials: CC
authors.lastname: Lin
mesh_terms: D000328:Adult; D000368:Aged; D001794:Blood Pressure; D015924:Blood Pressure Monitors; D001810:Blood Volume; D002302:Cardiac Output; D002405:Catheterization, Central Venous; D002407:Catheterization, Swan-Ganz; D002496:Central Venous Pressure; D002681:China; D004867:Equipment Design; D005260:Female; D006801:Humans; D008103:Liver Cirrhosis / Q000503:physiopathology / Q000601:surgery*; D016031:Liver Transplantation; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative / Q000295:instrumentation*; D011237:Predictive Value of Tests; D017534:Radial Artery; D012984:Software; D013997:Time Factors; D016278:Ventricular Function, Right