title: Is stroke volume variation a useful preload index in liver transplant recipients? A retrospective analysis.
abstract: BACKGROUND
  The right ventricular end-diastolic volume index (RVEDVI) is a good indicator of preload in patients undergoing liver transplantation. Although dynamic indices, such as stroke volume variation (SVV), have been used as reliable indicators in predicting fluid responsiveness, the evaluation of the relationship between SVV and direct preload status is limited. We investigated the relationship between SVV and RVEDVI, and tested the cutoff value of SVV to predict RVEDVI during liver transplantation.
  
  
  METHODS
  A total of 150 data pairs in 30 living donor liver transplant recipients were retrospectively investigated. Hemodynamic parameters, including SVV and RVEDVI were obtained from each patient at the 5 specific time points. Linear regression and receiver operating characteristic (ROC) curve analyses were performed.
  
  
  RESULTS
  The SVV significantly correlated with the RVEDVI (r = -0.616, P < 0.001). Cutoff values for the upper and lower tertiles of RVEDVI were 157 mL/m(2) and 128 mL/m(2), respectively. Tertile analysis indicated that upper tertile of RVEDVI had a significantly lower SVV than the middle tertile (median; 5% vs 8%, P < 0.05), and middle tertile of RVEDVI had a significantly lower SVV than the lower tertile (median; 8% vs 11%, P < 0.05). A 6% cutoff value of SVV estimated the upper tertile RVEDVI (>157 mL/m(2)) with the area under the curve of ROC curve of 0.832. A 9% cutoff value of SVV estimated the lower tertile RVEDVI (<128 mL/m(2)) with the area under the curve of ROC curve of 0.792.
  
  
  CONCLUSIONS
  SVV may be a valuable estimator of RVEDVI in patients undergoing liver transplantation.
authors: Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
authors: Sung-Hoon
authors: SH
authors: Kim
authors: Gyu-Sam
authors: GS
authors: Hwang
authors: Seon-Ok
authors: SO
authors: Kim
authors: Young-Kug
authors: YK
authors: Kim
mesh_terms: D000368:Aged; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D016031:Liver Transplantation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D012372:ROC Curve; D012189:Retrospective Studies; D020521:Stroke / Q000175:diagnosis / Q000473:pathology* / Q000628:therapy; D013318:Stroke Volume
keywords: liver transplantation; preload index; right ventricular end-diastolic volume index.; stroke volume variation
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