Evaluation on the Accuracy of Stroke Volume Variation in Blood Volume Monitoring during Induction in Patients Undergoing Coronary Artery Bypass Grafting / 中国医科大学学报

ABSTRACT

Objective To evaluate the accuracy of stroke volume variation(SVV)in blood volume monitoring during induction in patients undergo?ing coronary artery bypass grafting(CABG). Methods Thirty ASAⅡorⅢpatients,aged 53?74 year,BMI 21?27,NYHA classⅡorⅢ,scheduled for CABG were enrolled in this study. MAP,HR,CVP,SVV,cardiac output(CO),cardiac index(CI),stroke volume index(SVI)and systemic vascular resistance index(SVRI)were continuously measured by Vigileo/FloTrac system and recorded simultaneously at the following time pointsT1(baseline level)and T2(after induction and before intubation). Calculate the changes of SVV,CVP and CI(△SVV、△CVP and△CI). Pa?tients whose△CI≥15%were defined as the responders to the insufficiency of blood volume. The receiver operating characteristic(ROC)curve for SVV and CVP were plotted,and the area under the curve were calculated. Results Compared with T1,significant decrease in CO,CI and SVI was observed at T2 . Meanwhile,SVV increased from 8%±5%to 17%±12%(P=0.012). Twenty?four patients were responders to intravascular volume insufficiency due to induction. SVV were significantly higher in responders than in non?responders(20%±13%vs 9%±4%,P=0.036). A threshold SVV value of 10.5%allowed discrimination between responders and non?responders to blood volume insufficiency,with a sensitivity of 75%and a specificity of 80%. The area under the curve for SVV was 0.875,and the 95%confidence interval was 0.689 to 1.000. Conclusion SVV exhibited reliable sensitivity and specificity in monitoring blood volume changes during induction in patients undergoing CABG.