title: Utility of stroke volume variation measured using non-invasive bioreactance as a predictor of fluid responsiveness in the prone position.
abstract: The aim of this prospective study was to evaluate the usefulness of stroke volume variation (SVV) derived from NICOM®to predict fluid responsiveness in the prone position. Forty adult patients undergoing spinal surgery in the prone position were included in this study. We measured SVV from NICOM®(SVVNICOM) and FloTrac™/Vigileo™ systems (SVVVigileo), and pulse pressure variation (PPV) using automatic (PPVauto) and manual (PPVmanual) calculations at four time points including supine and prone positions, and before and after fluid loading of 6 ml kg-1colloid solution. Fluid responsiveness was defined as an increase in the cardiac index from Vigileo™ of ≥12 %. There were 19 responders and 21 non-responders. Prone positioning induced a significant decrease in SVVNICOM, SVVVigileo, PPVauto, and PPVmanual. However, all of these parameters successfully predicted fluid responsiveness in the prone position with area under the receiver-operator characteristic curves for SVVNICOM, SVVVigileo, PPVauto, and PPVmanualof 0.78 [95 % confidence interval (CI) 0.62-0.90, P = 0.0001], 0.79 (95 % CI 0.63-0.90, P = 0.0001), 0.76 (95 % CI 0.6-0.88, P = 0.0006), and 0.84 (95 % CI 0.69-0.94, P < 0.0001), respectively. The optimal cut-off values were 12 % for SVVNICOM, SVVVigileo, and PPVauto, and 10 % for PPVmanual. SVV from NICOM®successfully predicts fluid responsiveness during surgery in the prone position. This totally non-invasive technique for assessing individual functional intravenous volume status would be useful in a wide range of surgeries performed in the prone position.
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
authors.forename: Jeong Jin
authors.initials: JJ
authors.lastname: Min
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea. jonghwanlee75@gmail.com.
authors.forename: Jong-Hwan
authors.initials: JH
authors.lastname: Lee
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
authors.forename: Kwan Young
authors.initials: KY
authors.lastname: Hong
authors.affiliation: Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea.
authors.forename: Soo Joo
authors.initials: SJ
authors.lastname: Choi
mesh_terms: D000368:Aged; D062186:Arterial Pressure; D001331:Automation; D001794:Blood Pressure; D002302:Cardiac Output; D003102:Colloids / Q000737:chemistry; D004566:Electrodes; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics; D006801:Humans; D007432:Intraoperative Period; D008297:Male; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009991:Oscillometry; D016684:Prone Position; D011446:Prospective Studies; D015203:Reproducibility of Results; D013131:Spine / Q000601:surgery*; D013318:Stroke Volume; D016683:Supine Position
chemical_list: D003102:Colloids
keywords: Cardiac output; Fluids therapy; Heart; Intraoperative; Monitoring; Prone position; Spinal surgery