Comparison between respiratory changes in the inferior vena cava diameter and pulse pressure variation to predict fluid responsiveness in postoperative patients

Comparison between respiratory changes in the inferior vena cava diameter and pulse pressure variation to predict fluid responsiveness in postoperative patients

Author de Oliveira, Olivia Haun Autor UNIFESP Google Scholar
Rezende de Freitas, Flavio Geraldo Autor UNIFESP Google Scholar
Ladeira, Renata Teixeira Autor UNIFESP Google Scholar
Fischer, Claudio Henrique Autor UNIFESP Google Scholar
Bafi, Antonio Tonete Autor UNIFESP Google Scholar
Pontes Azevedo, Luciano Cesar Autor UNIFESP Google Scholar
Machado, Flavia Ribeiro Autor UNIFESP Google Scholar
Abstract Purpose: The objective of our study was to assess the reliability of the distensibility index of the inferior vena cava (dIVC) as a predictor of fluid responsiveness in postoperative, mechanically ventilated patients and compare its accuracy with that of the pulse pressure variation (PPV) measurement. Materials and methods: We included postoperative mechanically ventilated and sedated patients who underwent volume expansion with 500 mL of crystalloids over 15 minutes. A response to fluid infusion was defined as a 15% increase in the left ventricular outflow tract velocity time integral according to transthoracic echocardiography. The inferior vena cava diameters were recorded by a subcostal view using the M-mode and the PPV by automatic calculation. The receiver operating characteristic (ROC) curves were generated for the baseline dIVC and PPV. Results: Twenty patients were included. The area under the ROC curve for dIVC was 0.84 (95% confidence interval, 0.63-1.0), and the best cutoff value was 16% (sensitivity, 67%

specificity, 100%). The area under the ROC curve for PPV was 0.92 (95% confidence interval, 0.76-1.0), and the best cutoff was 12.4% (sensitivity, 89%

specificity, 100%). A noninferiority test showed that dIVC cannot replace PPV to predict fluid responsiveness (P = .28). Conclusion: The individual PPV discriminative properties for predicting fluid responsiveness in postoperative patients seemed superior to those of dIVC. (C) 2016 Elsevier Inc. All rights reserved.
Keywords Fluid therapy
Hemodynamics
Inferior vena cava
Echocardiography
Postoperative care
xmlui.dri2xhtml.METS-1.0.item-coverage Philadelphia
Language English
Date 2016
Published in Journal Of Critical Care. Philadelphia, v. 34, p. 46-49, 2016.
ISSN 0883-9441 (Sherpa/Romeo, impact factor)
Publisher W B Saunders Co-Elsevier Inc
Extent 46-49
Origin http://dx.doi.org/10.1016/j.jcrc.2016.03.017
Access rights Closed access
Type Article
Web of Science ID WOS:000377704200011
URI https://repositorio.unifesp.br/handle/11600/57520

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