Plethysmography Variability Index and Stroke Volume Variation Changes in Relation to Central Venous Pressure Changes During Living Related Donor Right Hepatotomy: A Diagnostic Test Accuracy

2021 ◽  
Author(s):  
Yasmin Abdelsalam Kamel ◽  
Amany Said Ammar ◽  
Omnai Gamal Baiomy ◽  
Mamdouh El-Sayed Lotfi ◽  
Khaled Ahmed Yassen
Keyword(s):  
Stroke Volume ◽  
Stroke Volume Variation ◽  
Venous Pressure ◽  
Test Accuracy ◽  
Central Venous ◽  
Variability Index ◽  
Related Donor ◽  
Living Related ◽  
Pressure Changes ◽  
Living Related Donor

scholarly journals Prediction of Volume Responsiveness by Stroke Volume Variation vs. Central Venous Pressure in Children Undergoing Fontan Operation

2020 ◽  
Author(s):  
Yun'an Song ◽  
Huiyan Hou ◽  
Jie Bai ◽  
Hongbin Gu
Keyword(s):  
Stroke Volume ◽  
Stroke Volume Variation ◽  
Single Ventricle ◽  
Fontan Operation ◽  
Venous Pressure ◽  
Central Venous ◽  
Volume Responsiveness ◽  
Before And After ◽  
Fontan Patients ◽  
Volume Challenge

Abstract Background: Fontan operation is a palliative medical procedure performed on children with single-ventricle defects. As postoperative success of the procedure largely depends on the preload volume, it is necessary to ensure the effective volume of systemic circulation by maintaining an appropriate pressure gradient between the systemic vein and the left atrium. However, there is a lack of effective indexes to evaluate volume responsiveness in Fontan patients. Stroke volume variation (SVV) is a dynamic hemodynamic parameter based on cardiopulmonary interaction in mechanical ventilation. This study is to validate the sensitivity and specificity of SVV vs. central venous pressure (CVP) in assessing volume responsiveness of Fontan patients.Method: 64 children were included in this prospective study with single-ventricle who underwent modified Fontan operation between May 2018 and January 2020. Patients were given 10ml·kg− 1 albumin for volume challenge within 10 min after CPB. Before and after volume challenge, the invasive arterial pressure module was connected to Mostcare™ equipment to collect SBP, MBP, DBP, SVV, CI and SVRI dynamically in a time window of 30 s at a frequency of 1000 Hz. According to the range of CI change, patients with ΔCI ≥ 15% were classified into response (R) group and patients with ΔCI < 15% into non-response (NR) group. Using SVV and CVP as indicators, the ROC of the patients was established, and the AUC, diagnostic threshold, sensitivity and specificity were calculated.Results: The 64 pediatric patients included with a mean age of 4.85 ± 1.20 years, a mean height of 98.00 ± 16.74 cm and a mean weight of 15.65 ± 5.37 kg. The SVV value was 17.15 ± 3.97% and 13.45 ± 2.45% before and after fluid challenge treatment vs. 18.60 ± 1.83 mmHg and 20.20 ± 2.39 mmHg for CVP in responders. The AUC of SVV was 0.74 (95% confidence interval [CI] 0.54–0.94, P < 0.05) and the cutoff value was 16%, offering a sensitivity of 50% and a specificity of 91.7% vs.0.70 (95% CI 0.50–0.92, P > 0.05), 19.5 mmHg, 58% and 76% for CVP.Conclusion: SVV exhibited a good predictive value for volume responsiveness in pediatric Fontan patients. Appropriate volume therapy according to SVV could improve the cardiac function of such patients.Trial registration: This research was registered in Chinese Clinical Trail Registry on Jan 26, 2018. Registration number is ChiCTR1800014654.Registry URL is http://www.chictr.org.cn/showproj.aspx?proj=25019. This observational prospective study was approved by the Local Ethics Committee of Shanghai Children’s Medical Center affiliated to Shanghai Jiao Tong University (SCMCIRB-K2017035)

scholarly journals A comparative study of pulse pressure variation, stroke volume variation and central venous pressure in patients undergoing kidney transplantation

2021 ◽  
Author(s):  
KM Kim ◽  
GS Kim ◽  
M Han
Keyword(s):  
Kidney Transplantation ◽  
Stroke Volume ◽  
Fluid Responsiveness ◽  
Pulse Pressure ◽  
Stroke Volume Variation ◽  
Venous Pressure ◽  
Fluid Management ◽  
Pressure Variation ◽  
Fluid Loading ◽  
Central Venous

Introduction: Optimal intraoperative fluid management guided by central venous pressure (CVP), a traditional intravascular volume status indicator, has improved transplanted graft function during kidney transplantation (KT). Pulse pressure variation (PPV) and stroke volume variation (SVV) – dynamic preload indexes – are robust predictors of fluid responsiveness. This study aimed to compare the accuracy of PPV and CVP against SVV in predicting fluid responsiveness in terms of cost-effectiveness after a standardised empiric volume challenge in KT patients. Methods: 36 patients undergoing living-donor KT were analysed. PPV, SVV, CVP and cardiac index (CI) were measured before and after fluid loading with a hydroxyethyl starch solution (7 mL/kg of ideal body weight). Patients were classified as responders (n = 12) or non-responders (n = 24) to fluid loading when CI increases were ≥ 10% or < 10%, respectively. The ability of PPV, SVV and CVP to predict fluid responsiveness was assessed using receiver operating characteristic (ROC) curves. Results: SVV and CVP measured before fluid loading were correlated with changes in CI caused by fluid expansion (ρ = 0.33, p = 0.049 and ρ = −0.37, p = 0.026) in contrast to PPV (ρ = 0.14, p = 0.429). The ROC analysis showed that SVV and CVP predicted response to volume loading (area under the ROC curve = 0.781 and 0.727, respectively; p < 0.05). Conclusion: Under the conditions of our study, SVV and CVP exhibited similar performance in predicting fluid responsiveness and could inform fluid management during KT as compared with PPV.

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