Abstract:
PURPOSE:The ability of the global end-diastolic volume index (GEDVI) and respiratory variations in left ventricular outflow tract velocity (ΔVTI(LVOT)) for prediction of fluid responsiveness is still under debate. The aim of the present study was to challenge the predictive power of GEDVI and ΔVTI(LVOT) compared with pulse pressure variation (PPV) and stroke volume variation (SVV) in a large patient population. MATERIAL AND METHODS:Ninety-two patients were studied before coronary artery surgery. Each patient was monitored with central venous pressure (CVP), the PiCCO system (Pulsion Medical Systems, Munich, Germany), and transesophageal echocardiography. Responders were defined as those who increased their stroke volume index by greater than 15% (ΔSVI(TPTD) >15%) during passive leg raising. RESULTS:Central venous pressure showed no significant correlation with ΔSVI(TPTD) (r = -0.06, P = .58), in contrast to PPV (r = 0.71, P < .0001), SVV (r = 0.61, P < .0001), GEDVI (r = -0.54, P < .0001), and ΔVTI(LVOT) (r = 0.54, P < .0001). The best area under the receiver operating characteristic curve (AUC) predicting ΔSVI(TPTD) greater than 15% was found for PPV (AUC, 0.82; P < .0001) and SVV (AUC, 0.77; P < .0001), followed by ΔVTI(LVOT) (AUC, 0.74; P < .0001) and GEDVI (AUC, 0.71; P = .0006), whereas CVP was not able to predict fluid responsiveness (AUC, 0.58; P = .18). CONCLUSIONS:In contrast to CVP, GEDVI and ΔVTI(LVOT) reliably predicted fluid responsiveness under closed-chest conditions. Pulse pressure variation and SVV showed the highest accuracy.
journal_name
J Crit Carejournal_title
Journal of critical careauthors
Broch O,Renner J,Gruenewald M,Meybohm P,Höcker J,Schöttler J,Steinfath M,Bein Bdoi
10.1016/j.jcrc.2011.07.073subject
Has Abstractpub_date
2012-06-01 00:00:00pages
325.e7-13issue
3eissn
0883-9441issn
1557-8615pii
S0883-9441(11)00366-2journal_volume
27pub_type
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journal_title:Journal of critical care
pub_type: 杂志文章,多中心研究
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journal_title:Journal of critical care
pub_type: 历史文章,杂志文章
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pub_type: 杂志文章,随机对照试验
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更新日期:2016-04-01 00:00:00
abstract::Hypernatremia is common in intensive care units. It has detrimental effects on various physiologic functions and was shown to be an independent risk factor for increased mortality in critically ill patients. Mechanisms of hypernatremia include sodium gain and/or loss of free water and can be discriminated by clinical ...
journal_title:Journal of critical care
pub_type: 杂志文章,评审
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journal_title:Journal of critical care
pub_type: 杂志文章
doi:10.1016/j.jcrc.2013.12.007
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更新日期:1997-03-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章,评审
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journal_title:Journal of critical care
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更新日期:2019-04-01 00:00:00
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pub_type: 临床试验,杂志文章
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journal_title:Journal of critical care
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pub_type: 临床试验,杂志文章
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更新日期:2018-08-01 00:00:00
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journal_title:Journal of critical care
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更新日期:2006-06-01 00:00:00
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journal_title:Journal of critical care
pub_type: 杂志文章
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更新日期:2015-02-01 00:00:00
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journal_title:Journal of critical care
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更新日期:2019-06-01 00:00:00
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更新日期:2017-12-01 00:00:00
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更新日期:2016-12-01 00:00:00
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pub_type: 杂志文章
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