title: [The value of brachial artery peak velocity variation during the Valsalva maneuver to predict fluid responsiveness].
abstract: Objective:To evaluate whether brachial artery peak velocity variation(ΔVp) during a Valsalva maneuver(VM) could predict fluid responsiveness in spontaneously breathing patients.Methods:Ninety-six patients required radial artery catheter for elective surgery of Ningbo Yinzhou People's Hospital from December 2014 to June 2016 were enrolled. The brachial artery Doppler signal was recorded to measure the ΔVp while the VM was performed.Then doing the volume expansion (VE) , the cardiac output variation (ΔCO) before and after VE were measured.Pearson correlational analyses were conducted between ΔVp and ΔCO. Also the sensitivity and specificity of ΔVp were determined in predicting fluid responsiveness by the receiver operating characteristic (ROC) curve.Results:Patients were classified as group responders (n=24) and group non-responders (n=72). Responder was defined as cardiac output increased≥15% after VE.The ΔVp correlated well with ΔCO (r=0.792,P<0.01). The area under ROC curve was 0.903, with the ΔVp cut-off of 33%, the sensitivity of 87% and the specificity of 82%(P<0.01).Conclusion:Brachial artery peak velocity variation during a valsalva maneuver is a feasible method for predicting fluid responsiveness in spontaneously breathing patients.
authors.affiliation: Department of Anesthesia, Second Affiliated Hospital of Zhejiang University, Hangzhou 310009, China.
authors.forename: L F
authors.initials: LF
authors.lastname: Sheng
authors.forename: M
authors.initials: M
authors.lastname: Yan
authors.forename: F J
authors.initials: FJ
authors.lastname: Zhang
authors.forename: Q S
authors.initials: QS
authors.lastname: Ren
authors.forename: S H
authors.initials: SH
authors.lastname: Yu
authors.forename: M
authors.initials: M
authors.lastname: Wu
mesh_terms: D019540:Area Under Curve; D001916:Brachial Artery; D002302:Cardiac Output; D015150:Echocardiography, Doppler; D005440:Fluid Therapy; D006801:Humans; D012372:ROC Curve; D013318:Stroke Volume; D014636:Valsalva Maneuver
keywords: Blood flow velocity; Brachial artery; Lung volume measurements; Respiration; Valsalva maneuver