title: Dynamic Variables Fail to Predict Fluid Responsiveness in an Animal Model With Pericardial Effusion.
abstract: OBJECTIVE
  The reliability of dynamic and volumetric variables of fluid responsiveness in the presence of pericardial effusion is still elusive. The aim of the present study was to investigate their predictive power in a porcine model with hemodynamic relevant pericardial effusion.
  
  
  METHODS
  A single-center animal investigation.
  
  
  METHODS
  Twelve German domestic pigs.
  
  
  METHODS
  Pigs were studied before and during pericardial effusion. Instrumentation included a pulmonary artery catheter and a transpulmonary thermodilution catheter in the femoral artery. Hemodynamic variables like cardiac output (COPAC) and stroke volume (SVPAC) derived from pulmonary artery catheter, global end-diastolic volume (GEDV), stroke volume variation (SVV), and pulse-pressure variation (PPV) were obtained.
  
  
  RESULTS
  At baseline, SVV, PPV, GEDV, COPAC, and SVPAC reliably predicted fluid responsiveness (area under the curve 0.81 [p = 0.02], 0.82 [p = 0.02], 0.74 [p = 0.07], 0.74 [p = 0.07], 0.82 [p = 0.02]). After establishment of pericardial effusion the predictive power of dynamic variables was impaired and only COPAC and SVPAC and GEDV allowed significant prediction of fluid responsiveness (area under the curve 0.77 [p = 0.04], 0.76 [p = 0.05], 0.83 [p = 0.01]) with clinically relevant changes in threshold values.
  
  
  CONCLUSIONS
  In this porcine model, hemodynamic relevant pericardial effusion abolished the ability of dynamic variables to predict fluid responsiveness. COPAC, SVPAC, and GEDV enabled prediction, but their threshold values were significantly changed.
authors: Departments of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Germany. Electronic address: ole.broch@uksh.de.
authors: Ole
authors: O
authors: Broch
authors: Departments of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: Jochen
authors: J
authors: Renner
authors: Anesthesiology, Intensive Care Medicine, and Pain Therapy, University Hospital, Frankfurt, Germany.
authors: Patrick
authors: P
authors: Meybohm
authors: Experimental Anesthesiology, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: Martin
authors: M
authors: Albrecht
authors: Departments of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: Jan
authors: J
authors: Höcker
authors: Cardiothoracic and Vascular Surgery, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: Assad
authors: A
authors: Haneya
authors: Departments of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: Markus
authors: M
authors: Steinfath
authors: Anesthesiology and Intensive Care Medicine, Asklepios Hospital St. Georg, Hamburg, Germany.
authors: Berthold
authors: B
authors: Bein
authors: Departments of Anesthesiology and Intensive Care Medicine, University Hospital Schleswig-Holstein, Campus Kiel, Germany.
authors: Matthias
authors: M
authors: Gruenewald
mesh_terms: D000818:Animals; D004195:Disease Models, Animal; D005260:Female; D005440:Fluid Therapy; D006439:Hemodynamics / Q000502:physiology*; D008297:Male; D010490:Pericardial Effusion / Q000503:physiopathology* / Q000628:therapy; D015203:Reproducibility of Results; D013552:Swine
keywords: dynamic variables; fluid responsiveness; heart-lung interaction; pericardial effusion; porcine model; preload