Abstract:
BACKGROUND:The objective of this study was to determine whether assessment of stroke volume (SV) and measurement of exhaled end-tidal carbon dioxide [Formula: see text] during an end-expiratory occlusion (EEO) test can predict fluid responsiveness in the operating theatre. METHODS:Forty-two subjects monitored by oesophageal Doppler who required i.v. fluids during surgery were studied. Haemodynamic variables [heart rate, non-invasive arterial pressure, SV, cardiac output (CO), respiratory variation of SV (ΔrespSV), variation of SV during EEO, and E'(CO₂) were measured at baseline, during EEO (Δ(EEO)), and after fluid expansion. Responders were defined by an increase in SV over 15% after infusion of 500 ml of crystalloid solution. RESULTS:Of the 42 subjects, 28 (67%) responded to fluid infusion. A cut-off of >2.3% ΔSV(EEO) predicted fluid responsiveness with an area under the receiver-operating characteristic (AUC) curve of 0.78 [95% confidence interval (95% CI): 0.63-0.89, P=0.003]. The AUC of ΔrespSV was 0.89 (95% CI: 0.76-0.97, P<0.001). With an AUC of 0.68 (95% CI: 0.51-0.81, P=0.07), E'(CO₂)(EEO) was poorly predictive of fluid responsiveness. CONCLUSIONS:ΔSV(EEO) and ΔE'(CO₂) were unable to accurately predict fluid responsiveness during surgery.
journal_name
Br J Anaesthjournal_title
British journal of anaesthesiaauthors
Guinot PG,Godart J,de Broca B,Bernard E,Lorne E,Dupont Hdoi
10.1093/bja/aet582subject
Has Abstractpub_date
2014-06-01 00:00:00pages
1050-4issue
6eissn
0007-0912issn
1471-6771pii
S0007-0912(17)30791-2journal_volume
112pub_type
杂志文章abstract:Background:Retrospective clinical studies suggest there is a risk for neurodevelopmental impairment following early childhood exposure to anaesthesia. In the developing animal brain, including those of non-human primates (NHPs), anaesthetics induce apoptotic cell death. We previously reported that a 5 h isoflurane (ISO...
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journal_title:British journal of anaesthesia
pub_type: 临床试验,杂志文章,随机对照试验
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