Publication: Predicting fluid responsiveness using change in pulse pressure variation and stroke volume variation after tidal volume challenge in postoperative patients receiving lung protective ventilation
Issued Date
2020-08-01
Resource Type
ISSN
01252208
Other identifier(s)
2-s2.0-85089942509
Rights
Mahidol University
Rights Holder(s)
SCOPUS
Bibliographic Citation
Journal of the Medical Association of Thailand. Vol.103, No.8 (2020), 729-735
Suggested Citation
Pimsai Kunakorn, Sunthiti Morakul, Tananchai Petnak, Pongsasit Singhatas, Chawika Pisitsak Predicting fluid responsiveness using change in pulse pressure variation and stroke volume variation after tidal volume challenge in postoperative patients receiving lung protective ventilation. Journal of the Medical Association of Thailand. Vol.103, No.8 (2020), 729-735. doi:10.35755/jmedassocthai.2020.08.10697 Retrieved from: https://repository.li.mahidol.ac.th/handle/20.500.14594/59198
Research Projects
Organizational Units
Authors
Journal Issue
Thesis
Title
Predicting fluid responsiveness using change in pulse pressure variation and stroke volume variation after tidal volume challenge in postoperative patients receiving lung protective ventilation
Other Contributor(s)
Abstract
© JOURNAL OF THE MEDICAL ASSOCIATION OF THAILAND. Background: Lung protective ventilation with low tidal volume (VT) is beneficial in patients with intermediate to high risk of post-operative pulmonary complications. However, during low VT ventilation, pulse pressure variation (PPV) and stroke volume variation (SVV) do not predict fluid responsiveness. Objective: To determine whether changes in PPV and SVV after transient increases in VT could predict fluid responsiveness. Materials and Methods: The authors recorded 20 measurements from 15 patients experiencing post-operative acute circulatory failure. The authors performed a VT challenge by transient increasing VT from 6 to 8 mL/kg (VT6-8), 8 to 10 mL/kg (VT8-10), and 6 to 10 mL/kg (VT6-10) of patients' predicted body weight. The change in PPV (ΔPPV) at VT6-8 (ΔPPV6-8), VT8-10 (ΔPPV8-10), VT6-10 (ΔPPV6-10), and the change in SVV (ΔSVV) at VT6-8 (ΔSVV6-8), VT8-10 (ΔSVV8-10), and VT6-10 (ΔSVV6-10) were recorded. Patients were classified as fluid responders if there was an increase in stroke volume of more than 10% after a fluid bolus. Results: Following the VT challenge, ΔPPV and ΔSVV failed to predict fluid responsiveness, with areas under the receiver operating characteristic curves (with 95% confidence intervals) of 0.49 (0.23 to 0.74), 0.54 (0.29 to 0.79), 0.52 (0.28 to 0.77) for ΔPPV6-8, ΔPPV8-10, and ΔPPV6-10, and 0.55 (0.30 to 0.80), 0.55 (0.31 to 0.80), and 0.59 (0.34 to 0.84) for ΔSVV6-8, ΔSVV8-10, and ΔSVV6-10, respectively. Conclusion: Changes in PPV and SVV after the VT challenge did not predict fluid responsiveness in post-operative patients with low VT ventilation.