Publication details
Comparison of pulse pressure and stroke volume variations measured by three monitors in high-risk surgical patients
| Authors | |
|---|---|
| Year of publication | 2024 |
| Type | Article in Periodical |
| Magazine / Source | HELIYON |
| MU Faculty or unit | |
| Citation | |
| web | https://www.sciencedirect.com/science/article/pii/S240584402415791X |
| Doi | http://dx.doi.org/10.1016/j.heliyon.2024.e39760 |
| Keywords | Fluid responsiveness; Pulse pressure variation; Stroke volume variation; Hemodynamic monitoring; General surgery; Pulse wave analysis |
| Description | Introduction Dynamic indices of fluid responsiveness (FR) such as pulse pressure variation (PPV) and stroke volume variation (SVV) differ among hemodynamic monitors, which use proprietary algorithms, and vary even over a short period of time. We aimed to compare the baseline values, fluctuation and predictive value for FR of PPV and SVV measured by three minimally invasive monitors. Patients and methods Twenty patients undergoing high-risk abdominal surgery were included and 45 fluid challenges were analysed. The patients were simultaneously monitored using Carescape B650, LiDCO Rapid and FloTrac/Vigileo system. Cardiac output (CO), PPV and SVV were recorded before and after the fluid challenge of 500 ml of balanced crystalloid solution. An increase in CO ? 15 % defined fluid responders. Concurrently recorded arterial waveform was used for offline calculation of PPV. Results Mean baseline values of the indices ranged between 8.6 % and 13.4 %. LiDCO showed higher fluctuation of indices compared to the other monitors. Area under the receiver operating characteristic curve (AUROC) ranged from 0.71 to 0.76 with optimal cut-off value between 7.5 % and 13.9 %. AUROC increased for all indices when FR was defined as an increase in stroke volume. Furthermore, a decrease in PPV or SVV after fluid challenge (?PPV, ?SVV) proved a better marker of FR (AUROC 0.82–0.93) than baseline values with a uniform threshold of approximately -3%. Conclusions Although a significant range of baselines variations and optimal cut-off values was observed, the predictive value of PPV and SVV from all the monitors was only moderate and comparable. Nevertheless, ?PPV and ?SVV appear to be a reliable and device-independent markers of FR. |