RESUMO
OBJECTIVE: To investigate the clinical values of blood pressure, heart rate and central venous pressure before and after fluid challenge to predict volume responsiveness. METHODS: A total of 86 fluid challenges in 39 patients with hemodynamic monitoring were retrospectively analyzed. Fluid challenges were separated into responder group and control group based on whether a 10% increase in cardiac output was achieved by fluid challenge. Such physiologic variables as systolic blood pressure (SBP), diastolic blood pressure (DBP), pulse pressure (PP), mean arterial pressure (MAP), heart rate (HR) and central venous pressure (CVP) were recorded before and after fluid challenges. RESULTS: ΔSBP, ΔDBP, ΔPP and ΔMAP before and after fluid challenge were significantly higher in responder group than control group. Logistic regression analysis identified ΔPP as the only independent predictor of fluid responsiveness (OR 1.100, 95%CI 1.037 - 1.167). Fluid responsiveness was predicted by ΔPP ≥ 5 mm Hg with sensitivity 78.4%, specificity 75.7%, positive predict value 76.3% and negative predict value 77.8%. Only ΔPP correlated with ΔCO by Pearson correlation analysis (r = 0.417, P < 0.001). CONCLUSION: ΔPP before and after fluid challenge can predict volume responsiveness while HR and CVP can not.
