These tools will no longer be maintained as of December 31, 2024. Archived website can be found here. PubMed4Hh GitHub repository can be found here. Contact NLM Customer Service if you have questions.


Pubmed for Handhelds

PUBMED FOR HANDHELDS

Search MEDLINE/PubMed

  • Title: Efficacy of functional hemodynamic parameters in predicting fluid responsiveness with pulse power analysis in surgical patients.
    Author: Cecconi M, Monti G, Hamilton MA, Puntis M, Dawson D, Tuccillo ML, Della Rocca G, Grounds RM, Rhodes A.
    Journal: Minerva Anestesiol; 2012 May; 78(5):527-33. PubMed ID: 22534733.
    Abstract:
    BACKGROUND: In this study we quantify the ability of dynamic cardiovascular parameters measured by the PulseCO™ algorithm of the LiDCO™plus monitor to predict the response to a fluid challenge in post-operative patients. METHODS: Surgical patients, admitted to the Intensive Care Unit from the operating theatre were monitored with the LiDCO™plus system. A number of static and dynamic cardiovascular measurements were recorded before and after a fluid challenge. Receiver Operator Characteristic (ROC) curve analysis was used to identify the baseline values, with optimum sensitivity and specificity, to predict responsiveness to a fluid challenge. RESULTS: Thirty-one patients were enrolled, and received protocol-based fluid challenges. Twelve (38%) responded by demonstrating an increase in stroke volume of >15%. Heart rate (HR) and central venous pressure (CVP) were not statistically different between responders and non-responders. Mean arterial pressure (mAP), systolic pressure variation (SPV), pulse pressure variation (PPV) and stroke volume variation (SVV) were statistically different between responders and non-responders. Parameters with a ROC area under the curve (AUC) significantly >0.5 included SPV 0.70 (0.52-0.88) P=0.046, PPV 0.87 (0.76-0.99) P<0.0002 and SVV 0.84 (0.71-0.96) P=0.0005. The best cut-off values (sensitivity and specificity) to predict fluid were SPV >9 mmHg (73%, 76%), PPV >13% (83%, 74%) and SVV >12.5% (75%, 83%). ROC analysis did not show the AUC to be significantly >0.5 for HR, mAP and CVP CONCLUSION: Dynamic indices measured by PulseCO™ (LiDCO) have a high sensitivity and specificity in predicting fluid responsiveness in sedated and mechanically ventilated patients. A cut-off value for PPV of 13% is the most sensitive and specific indicator of fluid responsiveness.
    [Abstract] [Full Text] [Related] [New Search]