Influence of tidal volume for stroke volume variation to predict fluid responsiveness in patients undergoing one-lung ventilation
Influence of tidal volume for stroke volume variation to predict fluid responsiveness in patients undergoing one-lung ventilation
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DOI：
10.1007/s00540-011-1200-x
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发表时间：
2011-10-01
影响因子：
2.8
通讯作者：
Okutani, Ryu
中科院分区：
文献类型：
--
作者：
Suehiro, Koichi;Okutani, Ryu
我们设计了这项研究，以确定在不同潮气量下进行单肺通气(OLV)的患者对每搏输出量变化(SVV)液体反应性的预测价值。将所有拟行肺叶切除术的患者按潮气量随机分为两组：H组：潮气量8ml/kg(n=36)；L组：潮气量6ml/kg(n=37)。开始OLV后，给予6%羟乙基淀粉500ml，30min进行容量负荷。使用Vigileo-FloTrac系统测量容量负荷前后的血流动力学参数。两组患者被分为液体反应者和无反应者，反应者被定义为心脏指数在扩容后每千日元增加15%。H组和L组受试者操作特征曲线下面积分别为0.776和0.648，其最佳阈值分别为10.5%(敏感度85.7%；特异度66.7%)和8%(敏感度69.5%；特异度64.3%)。
We designed this study to determine the predictive value for fluid responsiveness of stroke volume variation (SVV) in patients undergoing one-lung ventilation (OLV), ventilated at different tidal volumes. All patients scheduled for pulmonary lobectomy were randomized into two groups according to their tidal volume [group H: tidal volume 8 ml/kg (n = 36); group L: tidal volume 6 ml/kg (n = 37)]. After starting OLV, volume loading was performed by administration of 500 ml 6% hydroxyethylated starch for 30 min. Hemodynamic variables were measured before and after volume loading using the Vigileo-FloTrac system. Patients in both groups were divided into fluid responders and non-responders, and responders were defined as those who demonstrated an increase in cardiac index a parts per thousand yen15% after volume expansion. The area under the receiver operating characteristic curve for SVV to discriminate between responders and non-responders was 0.776 in group H and 0.648 in group L. The optimal threshold value of SVV was 10.5% (sensitivity, 85.7%; specificity, 66.7%) in group H and 8% (sensitivity, 69.5%; specificity, 64.3%) in group L. We found that SVV could predict fluid responsiveness in patients undergoing OLV with acceptable levels of sensitivity and specificity only when tidal volume is at least 8 ml/kg.