Arrêt de service programmé du vendredi 10 juin 16h jusqu’au lundi 13 juin 9h. Pour en savoir plus
Accéder directement au contenu Accéder directement à la navigation
Article dans une revue

The predictability of dynamic preload indices depends on the volume of fluid challenge A prospective observational study in the operating theater

Abstract : This study was designed to assess the association between volume of fluid challenge (FC) and predictability of respiratory variation of stroke volume (Delta respSV) in the operating theater. Patients undergoing intermediate/high-risk surgery and monitored by esophageal Doppler monitoring (EDM) were prospectively included. All patients were under general anesthesia and mechanically ventilated. Exclusion criteria were frequent ectopic beats or preoperative arrhythmia, right ventricular failure, and spontaneous breathing. Hemodynamic parameters and esophageal Doppler indices (SV, cardiac output, Delta respSV) were collected before, after infusion of 250 mL, and after infusion of 500mL of crystalloid solution. Responders were defined by a >15% increase of stroke volume after FC at each step. After infusion of a 250 mL FC, 41 patients (32%) were classified as fluid responders (R250). After infusion of a 500 mL FC, 80 patients (63%) were classified as fluid responders (R500). The predictability of Delta respSV was fair with an area under the curve (AUC) of 0.79 (95% CI 0.71-0.86, P<.001) to predict fluid responsiveness with a 250 mL FC. With an AUC of 0.94 (95% CI 0.88-0.97, P<.0001), Delta respSV presented an excellent ability to predict fluid responsiveness with a 500-mL FC. Predictability of Delta respSV changed with the volume of fluid infused to assess fluid responsiveness. The accuracy of Delta respSV was higher with 500 mL than with 250 mL. Bedside studies evaluating the predictability of dynamic preload indices should define fluid responsiveness as a >15% increase of SV in response to a 500-mL FC.
Type de document :
Article dans une revue
Liste complète des métadonnées

https://hal-u-picardie.archives-ouvertes.fr/hal-03577392
Contributeur : Louise Dessaivre Connectez-vous pour contacter le contributeur
Soumis le : mercredi 16 février 2022 - 16:37:27
Dernière modification le : jeudi 17 février 2022 - 03:36:29

Lien texte intégral

Identifiants

Citation

Pierre-Gregoire Guinot, Julien Marc, Bruno Broca, Thomas Archange, Stephane Bar, et al.. The predictability of dynamic preload indices depends on the volume of fluid challenge A prospective observational study in the operating theater. Medicine, 2018, 97 (42), ⟨10.1097/MD.0000000000012848⟩. ⟨hal-03577392⟩

Partager

Métriques

Consultations de la notice

5