title: Prediction of volume-responsiveness during one-lung ventilation: a comparison of static, volumetric, and dynamic parameters of cardiac preload.
abstract: OBJECTIVE
  The aim of this study was to evaluate the ability of static, volumetric, and dynamic parameters of cardiac preload to predict volume responsiveness during one-lung ventilation (OLV).
  
  
  METHODS
  Prospective experimental study.
  
  
  METHODS
  Laboratory of the animal facility of the University Medical Center Hamburg-Eppendorf.
  
  
  METHODS
  Twenty-three German domestic pigs.
  
  
  METHODS
  Hypovolemia was induced by withdrawing 20 mL/kg body weight (BW) of blood. OLV was established, and the volume withdrawn was re-transfused in 3 volume-loading steps, each consisting of 7 mL/kg BW. An ultrasonic flow probe around the pulmonary artery was used to measure the stroke-volume index (SVI) and to evaluate the volume response. An increase in the SVI of ≥ 15% was considered a positive response. For each measurement time point, central venous pressure (CVP), left atrial pressure (LAP), the global end-diastolic volume index (GEDI), stroke-volume variation (SVV), and pulse-pressure variation (PPV) were recorded. The ability to predict volume responsiveness was assessed using ROC analysis.
  
  
  RESULTS
  A total of 69 volume loading steps were performed, 48 of which showed a positive volume response. ROC analysis revealed the following area under the curve (AUC) values: CVP, 0.88; LAP, 0.65; GEDI, 0.75; SVV, 0.78; and PPV, 0.83. A comparison of the areas under the ROC curves did not reveal any statistically significant differences (p>0.05), with the exception of LAP compared with CVP (p = 0.005).
  
  
  CONCLUSIONS
  Under these OLV experimental conditions, the volumetric and dynamic parameters of preload, as well as CVP, seemed to be of similar value in predicting volume responsiveness.
authors: Department of Anesthesiology, Center of Anesthesiology and Intensive Care Medicine, University Medical Center Hamburg-Eppendorf, Hamburg, Germany.
authors: Constantin J C
authors: CJ
authors: Trepte
authors: Sebastian A
authors: SA
authors: Haas
authors: Rainer
authors: R
authors: Nitzschke
authors: Cornelie
authors: C
authors: Salzwedel
authors: Alwin E
authors: AE
authors: Goetz
authors: Daniel A
authors: DA
authors: Reuter
mesh_terms: D000465:Algorithms; D000818:Animals; D019540:Area Under Curve; D001810:Blood Volume / Q000502:physiology*; D002496:Central Venous Pressure / Q000502:physiology; D005260:Female; D006321:Heart / Q000502:physiology*; D020896:Hypovolemia / Q000503:physiopathology; D061810:One-Lung Ventilation; D011651:Pulmonary Artery / Q000502:physiology; D012372:ROC Curve; D013318:Stroke Volume / Q000502:physiology; D013552:Swine; D013990:Tidal Volume / Q000502:physiology
keywords: cardiac preload; goal-directed therapy; hemodynamic monitoring; one-lung ventilation; volume response