Abstract:
OBJECTIVES:The aim of this study was to evaluate the ability of static, volumetric, and dynamic parameters of cardiac preload to predict volume responsiveness during one-lung ventilation (OLV). DESIGN:Prospective experimental study. SETTING:Laboratory of the animal facility of the University Medical Center Hamburg-Eppendorf. PARTICIPANTS:Twenty-three German domestic pigs. INTERVENTIONS:Hypovolemia was induced by withdrawing 20 mL/kg body weight (BW) of blood. OLV was established, and the volume withdrawn was re-transfused in 3 volume-loading steps, each consisting of 7 mL/kg BW. An ultrasonic flow probe around the pulmonary artery was used to measure the stroke-volume index (SVI) and to evaluate the volume response. An increase in the SVI of ≥ 15% was considered a positive response. For each measurement time point, central venous pressure (CVP), left atrial pressure (LAP), the global end-diastolic volume index (GEDI), stroke-volume variation (SVV), and pulse-pressure variation (PPV) were recorded. The ability to predict volume responsiveness was assessed using ROC analysis. MEASUREMENTS AND MAIN RESULTS:A total of 69 volume loading steps were performed, 48 of which showed a positive volume response. ROC analysis revealed the following area under the curve (AUC) values: CVP, 0.88; LAP, 0.65; GEDI, 0.75; SVV, 0.78; and PPV, 0.83. A comparison of the areas under the ROC curves did not reveal any statistically significant differences (p>0.05), with the exception of LAP compared with CVP (p = 0.005). CONCLUSIONS:Under these OLV experimental conditions, the volumetric and dynamic parameters of preload, as well as CVP, seemed to be of similar value in predicting volume responsiveness.
journal_name
J Cardiothorac Vasc Anesthjournal_title
Journal of cardiothoracic and vascular anesthesiaauthors
Trepte CJ,Haas SA,Nitzschke R,Salzwedel C,Goetz AE,Reuter DAdoi
10.1053/j.jvca.2013.05.003subject
Has Abstractpub_date
2013-12-01 00:00:00pages
1094-100issue
6eissn
1053-0770issn
1532-8422pii
S1053-0770(13)00278-4journal_volume
27pub_type
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journal_title:Journal of cardiothoracic and vascular anesthesia
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abstract::Appropriate anesthesia for LVAD placement needs to incorporate an understanding of the surgical procedure and LVAD physiology, the altered physiology and pharmacology of the cardiac failure patient, and a knowledge of the interaction of anesthesia with the potent cardiac drugs used in end-stage heart failure therapy. ...
journal_title:Journal of cardiothoracic and vascular anesthesia
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journal_title:Journal of cardiothoracic and vascular anesthesia
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更新日期:1995-02-01 00:00:00
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doi:10.1053/j.jvca.2006.01.018
更新日期:2006-08-01 00:00:00