Evaluation of volume responsiveness by pulse pressure variability and inferior vena cava dispensability index at different tidal volumes by mechanical ventilation
Braz. j. med. biol. res
;
52(9): e8827, 2019. tab, graf
Artículo
en Inglés
| LILACS
| ID: biblio-1019564
ABSTRACT
This study investigated the effects of tidal volume (TV) on the diagnostic value of pulse pressure variation (PPV) and the inferior vena cava dispensability index (IVC-DI) for volume responsiveness during mechanical ventilation. In patients undergoing elective surgery with mechanical ventilation, different TVs of 6, 9, and 12 mL/kg were given for two min. The left ventricular outflow tract velocity-time integral (VTI) was measured by transthoracic echocardiography. The IVC-DI was measured at sub-xyphoid transabdominal long axis. The PPV was measured via the radial artery and served as baseline. Index measurements were repeated after fluid challenge. VTI increased by more than 15% after fluid challenge, which was considered as volume responsive. Seventy-nine patients were enrolled, 38 of whom were considered positive volume responsive. Baseline data between the response group and the non-response group were similar. Receiver operating characteristic curve confirmed PPV accuracy in diagnosing an increase in volume responsiveness with increased TV. When TV was 12 mL/kg, the PPV area under the curve (AUC) was 0.93 and the threshold value was 15.5%. IVC-DI had the highest diagnostic accuracy at a TV of 9 mL/kg and an AUC of 0.79, with a threshold value of 15.3%. When TV increased to 12 mL/kg, the IVC-DI value decreased. When the TV was 9 and 12 mL/kg, PPV showed improved performance in diagnosing volume responsiveness than did IVC-DI. PPV diagnostic accuracy in mechanically ventilated patients was higher than IVC-DI. PPV accuracy in predicting volume responsiveness was increased by increasing TV.
Texto completo:
Disponible
Índice:
LILACS (Américas)
Asunto principal:
Respiración Artificial
/
Volumen Sistólico
/
Vena Cava Inferior
/
Presión Sanguínea
/
Volumen de Ventilación Pulmonar
Tipo de estudio:
Estudio pronóstico
Límite:
Adolescente
/
Adulto
/
Femenino
/
Humanos
/
Masculino
Idioma:
Inglés
Revista:
Braz. j. med. biol. res
Asunto de la revista:
Biologia
/
Medicina
Año:
2019
Tipo del documento:
Artículo
País de afiliación:
China
Institución/País de afiliación:
West China Hospital, Sichuan University, Wuhou District/CN
Similares
MEDLINE
...
LILACS
LIS