Assessment of stroke volume variation for prediction of fluid responsiveness using the modified FloTrac and PiCCOplus system.
Assessment of stroke volume variation for prediction of fluid responsiveness using the modified FloTrac and PiCCOplus system.
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DOI：
10.1186/cc6933
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发表时间：
2008
期刊：
影响因子：
15.1
通讯作者：
Zollinger, Andreas
中科院分区：
文献类型：
--
作者：
Hofer, Christoph K.;Senn, Alban;Weibel, Luc;Zollinger, Andreas
每搏输出量变异度（SVV）已多次被证明是液体反应性的可靠预测指标。各种器械允许对SVV进行自动化临床评估。本研究的目的是比较采用FloTrac™/Vigileo™系统和PiCCOplus™系统测定的SVV预测液体反应性。在接受择期心脏手术的患者中，通过径向FloTrac传感器测定SVVFloTrac，并通过股动脉PiCCO导管评估SVVPiCCO和脉压变化。每搏输出量通过经尿道热稀释法评估。在体位变化（从30°头高位到30°头低位）引起的容积变化前后记录所有变量。进行Pearson相关性、t检验和Bland-Altman分析。通过绘制每搏输出量变化超过25%的受试者工作特征曲线来确定曲线下面积。P < 0.05为有统计学意义。体位导致每搏输出量显著增加; SVVFloTrac和SVVPiCCO显著降低。SVVFloTrac和SVVPiCCO与每搏输出量变化的相关性相似。SVVFloTrac和SVVPiCCO的曲线下面积无显著差异;受试者工作特征曲线给出的最佳阈值为SVVFloTrac 9.6%（灵敏度91%，特异性83%）和SVVPiCCO 12.1%（灵敏度87%，特异性76%）。SVVFloTrac和SVVPiCCO之间存在临床可接受的一致性和强相关性。使用FloTrac™/Vigileo™和PiCCOplus™系统评估的SVV在预测液体反应性方面表现出相似的性能。与SVVPiCCO相比，SVVFloTrac具有更低的阈值。
Stroke volume variation (SVV) has repeatedly been shown to be a reliable predictor of fluid responsiveness. Various devices allow automated clinical assessment of SVV. The aim of the present study was to compare prediction of fluid responsiveness using SVV, as determined by the FloTrac™/Vigileo™ system and the PiCCOplus™ system. In patients who had undergone elective cardiac surgery, SVVFloTrac was determined via radial FloTrac sensor, and SVVPiCCO and pulse pressure variation were assessed via a femoral PiCCO catheter. Stroke volume was assessed by transpulmonary thermodilution. All variables were recorded before and after a volume shift induced by a change in body positioning (from 30° head-up position to 30° head-down position). Pearson correlation, t-test, and Bland-Altman analysis were performed. Area under the curve was determined by plotting receiver operating characteristic curves for changes in stroke volume in excess of 25%. P < 0.05 was considered statistically significant. Body positioning resulted in a significant increase in stroke volume; SVVFloTrac and SVVPiCCO decreased significantly. Correlations of SVVFloTrac and SVVPiCCO with change in stroke volume were similar. There was no significant difference between the areas under the curve for SVVFloTrac and SVVPiCCO; the optimal threshold values given by the receiver operating characteristic curves were 9.6% for SVVFloTrac (sensitivity 91% and specificity 83%) and 12.1% for SVVPiCCO (sensitivity 87% and specificity 76%). There was a clinically acceptable agreement and strong correlation between SVVFloTrac and SVVPiCCO. SVVs assessed using the FloTrac™/Vigileo™ and the PiCCOplus™ systems exhibited similar performances in terms of predicting fluid responsiveness. In comparison with SVVPiCCO, SVVFloTrac has a lower threshold value.
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影响因子：
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通讯作者：
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