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Assessing fluid responsiveness during open chest conditions

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Assessing fluid responsiveness during open chest conditions. / Reuter, D A; Goepfert, M S G; Goresch, T; Schmoeckel, M; Kilger, E; Goetz, A E.

In: BRIT J ANAESTH, Vol. 94, No. 3, 01.03.2005, p. 318-23.

Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review

Harvard

Reuter, DA, Goepfert, MSG, Goresch, T, Schmoeckel, M, Kilger, E & Goetz, AE 2005, 'Assessing fluid responsiveness during open chest conditions', BRIT J ANAESTH, vol. 94, no. 3, pp. 318-23. https://doi.org/10.1093/bja/aei043

APA

Reuter, D. A., Goepfert, M. S. G., Goresch, T., Schmoeckel, M., Kilger, E., & Goetz, A. E. (2005). Assessing fluid responsiveness during open chest conditions. BRIT J ANAESTH, 94(3), 318-23. https://doi.org/10.1093/bja/aei043

Vancouver

Reuter DA, Goepfert MSG, Goresch T, Schmoeckel M, Kilger E, Goetz AE. Assessing fluid responsiveness during open chest conditions. BRIT J ANAESTH. 2005 Mar 1;94(3):318-23. https://doi.org/10.1093/bja/aei043

Bibtex

@article{aea1364cc49040c39618720a769316e4,
title = "Assessing fluid responsiveness during open chest conditions",
abstract = "BACKGROUND: Measurement of ventilation-induced left ventricular stroke volume variations (SVV) or pulse pressure variations (PPV) is useful to optimize preload in patients after cardiac surgery. The aim of this study was to investigate the ability of SVV and PPV measured by arterial pulse contour analysis to assess fluid responsiveness in patients undergoing coronary artery bypass surgery during open-chest conditions.METHODS: We studied 22 patients immediately after midline sternotomy. We determined SVV, PPV, left ventricular end-diastolic area index by transoesophageal echocardiography, global end-diastolic volume index and cardiac index by thermodilution before and after removal of blood 500 ml and after volume substitution with hydroxyethyl starch 6%, 500 ml.RESULTS: Blood removal resulted in a significant increase in SVV from 6.7 (2.2) to 12.7 (3.8)%. PPV increased from 5.2 (2.5) to 11.9 (4.6)% (both P<0.001). Cardiac index decreased from 2.9 (0.6) to 2.3 (0.5) litres min(-1) m(-2) and global end-diastolic volume index decreased from 650 (98) to 565 (98) ml m(-2) (both P<0.025). Left ventricular end-diastolic area index did not change significantly. After fluid loading SVV decreased significantly to 6.8 (2.2)% and PPV decreased to 5.4 (2.1)% (both P<0.001). Concomitantly, cardiac index increased significantly to 3.3 (0.5) litres min(-1) m(-2) (P<0.001) and global end-diastolic volume index increased significantly to 663 (104) ml m(-2) (P<0.005). Left ventricular end-diastolic area index did not change significantly. We found a significant correlation between the increase in cardiac index caused by fluid loading and SVV as well as PPV before fluid loading (SVV, R=0.74, P<0.001; PPV, R=0.61, P<0.005). No correlations were found between values of global end-diastolic volume index or left ventricular end-diastolic area index before fluid loading and the increase in cardiac index.CONCLUSION: Measurement of SVV or PPV allows assessment of fluid responsiveness in hypovolaemic patients under open-chest and open-pericardium conditions. Thus, measuring heart-lung interactions may improve haemodynamic management during surgical procedures requiring mid-line sternotomy.",
keywords = "Adult, Aged, Cardiac Output, Coronary Artery Bypass, Echocardiography, Transesophageal, Female, Fluid Therapy, Hemodynamics, Humans, Hydroxyethyl Starch Derivatives, Intraoperative Care, Male, Middle Aged, Monitoring, Intraoperative, Pulsatile Flow, Stroke Volume, Thermodilution",
author = "Reuter, {D A} and Goepfert, {M S G} and T Goresch and M Schmoeckel and E Kilger and Goetz, {A E}",
year = "2005",
month = mar,
day = "1",
doi = "10.1093/bja/aei043",
language = "English",
volume = "94",
pages = "318--23",
journal = "BRIT J ANAESTH",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "3",

}

RIS

TY - JOUR

T1 - Assessing fluid responsiveness during open chest conditions

AU - Reuter, D A

AU - Goepfert, M S G

AU - Goresch, T

AU - Schmoeckel, M

AU - Kilger, E

AU - Goetz, A E

PY - 2005/3/1

Y1 - 2005/3/1

N2 - BACKGROUND: Measurement of ventilation-induced left ventricular stroke volume variations (SVV) or pulse pressure variations (PPV) is useful to optimize preload in patients after cardiac surgery. The aim of this study was to investigate the ability of SVV and PPV measured by arterial pulse contour analysis to assess fluid responsiveness in patients undergoing coronary artery bypass surgery during open-chest conditions.METHODS: We studied 22 patients immediately after midline sternotomy. We determined SVV, PPV, left ventricular end-diastolic area index by transoesophageal echocardiography, global end-diastolic volume index and cardiac index by thermodilution before and after removal of blood 500 ml and after volume substitution with hydroxyethyl starch 6%, 500 ml.RESULTS: Blood removal resulted in a significant increase in SVV from 6.7 (2.2) to 12.7 (3.8)%. PPV increased from 5.2 (2.5) to 11.9 (4.6)% (both P<0.001). Cardiac index decreased from 2.9 (0.6) to 2.3 (0.5) litres min(-1) m(-2) and global end-diastolic volume index decreased from 650 (98) to 565 (98) ml m(-2) (both P<0.025). Left ventricular end-diastolic area index did not change significantly. After fluid loading SVV decreased significantly to 6.8 (2.2)% and PPV decreased to 5.4 (2.1)% (both P<0.001). Concomitantly, cardiac index increased significantly to 3.3 (0.5) litres min(-1) m(-2) (P<0.001) and global end-diastolic volume index increased significantly to 663 (104) ml m(-2) (P<0.005). Left ventricular end-diastolic area index did not change significantly. We found a significant correlation between the increase in cardiac index caused by fluid loading and SVV as well as PPV before fluid loading (SVV, R=0.74, P<0.001; PPV, R=0.61, P<0.005). No correlations were found between values of global end-diastolic volume index or left ventricular end-diastolic area index before fluid loading and the increase in cardiac index.CONCLUSION: Measurement of SVV or PPV allows assessment of fluid responsiveness in hypovolaemic patients under open-chest and open-pericardium conditions. Thus, measuring heart-lung interactions may improve haemodynamic management during surgical procedures requiring mid-line sternotomy.

AB - BACKGROUND: Measurement of ventilation-induced left ventricular stroke volume variations (SVV) or pulse pressure variations (PPV) is useful to optimize preload in patients after cardiac surgery. The aim of this study was to investigate the ability of SVV and PPV measured by arterial pulse contour analysis to assess fluid responsiveness in patients undergoing coronary artery bypass surgery during open-chest conditions.METHODS: We studied 22 patients immediately after midline sternotomy. We determined SVV, PPV, left ventricular end-diastolic area index by transoesophageal echocardiography, global end-diastolic volume index and cardiac index by thermodilution before and after removal of blood 500 ml and after volume substitution with hydroxyethyl starch 6%, 500 ml.RESULTS: Blood removal resulted in a significant increase in SVV from 6.7 (2.2) to 12.7 (3.8)%. PPV increased from 5.2 (2.5) to 11.9 (4.6)% (both P<0.001). Cardiac index decreased from 2.9 (0.6) to 2.3 (0.5) litres min(-1) m(-2) and global end-diastolic volume index decreased from 650 (98) to 565 (98) ml m(-2) (both P<0.025). Left ventricular end-diastolic area index did not change significantly. After fluid loading SVV decreased significantly to 6.8 (2.2)% and PPV decreased to 5.4 (2.1)% (both P<0.001). Concomitantly, cardiac index increased significantly to 3.3 (0.5) litres min(-1) m(-2) (P<0.001) and global end-diastolic volume index increased significantly to 663 (104) ml m(-2) (P<0.005). Left ventricular end-diastolic area index did not change significantly. We found a significant correlation between the increase in cardiac index caused by fluid loading and SVV as well as PPV before fluid loading (SVV, R=0.74, P<0.001; PPV, R=0.61, P<0.005). No correlations were found between values of global end-diastolic volume index or left ventricular end-diastolic area index before fluid loading and the increase in cardiac index.CONCLUSION: Measurement of SVV or PPV allows assessment of fluid responsiveness in hypovolaemic patients under open-chest and open-pericardium conditions. Thus, measuring heart-lung interactions may improve haemodynamic management during surgical procedures requiring mid-line sternotomy.

KW - Adult

KW - Aged

KW - Cardiac Output

KW - Coronary Artery Bypass

KW - Echocardiography, Transesophageal

KW - Female

KW - Fluid Therapy

KW - Hemodynamics

KW - Humans

KW - Hydroxyethyl Starch Derivatives

KW - Intraoperative Care

KW - Male

KW - Middle Aged

KW - Monitoring, Intraoperative

KW - Pulsatile Flow

KW - Stroke Volume

KW - Thermodilution

U2 - 10.1093/bja/aei043

DO - 10.1093/bja/aei043

M3 - SCORING: Journal article

C2 - 15591333

VL - 94

SP - 318

EP - 323

JO - BRIT J ANAESTH

JF - BRIT J ANAESTH

SN - 0007-0912

IS - 3

ER -