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Pulse pressure variation and pleth variability index as predictors of fluid responsiveness in patients undergoing spinal surgery in the prone position

Other Titles
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Authors
 Do-Hyeong Kim  ;  Seokyung Shin  ;  Ji Young Kim  ;  Seung Hyun Kim  ;  Minju Jo  ;  Yong Seon Choi 
Citation
 Therapeutics and Clinical Risk Management, Vol.14 : 1175-1183, 2018 
Journal Title
 Therapeutics and Clinical Risk Management 
ISSN
 1176-6336 
Issue Date
2018
Keywords
fluid therapy ; intraoperative monitoring ; prone position ; stroke volume
Abstract
Background: This study investigated the ability of pulse pressure variation (PPV) and pleth variability index (PVI) to predict fluid responsiveness of patients undergoing spinal surgery in the prone position. Patients and methods: A total of 53 patients undergoing posterior lumbar spinal fusion in the prone position on a Jackson table were studied. PPV, PVI, and hemodynamic and respiratory variables were measured both before and after the administration of 6 mL/kg colloid in both the supine and prone positions. Fluid responsiveness was defined as a 15% or greater increase in stroke volume index, as assessed by esophageal Doppler monitor after fluid loading. Results: In the supine position, 40 patients were responders. The areas under the receiver operating characteristic (ROC) curves for PPV and PVI were 0.783 [95% CI 0.648-0.884, P<0.001] and 0.814 (95% CI 0.684-0.908, P<0.001), respectively. The optimal cut-off values of PPV and PVI were 10% (sensitivity 75%, specificity 62%) and 8% (sensitivity 78%, specificity 77%), respectively. In the prone position, 27 patients were responders. The areas under the ROC curves for PPV and PVI were 0.781 (95% CI 0.646-0.883, P<0.001) and 0.756 (95% CI 0.618-0.863, P<0.001), respectively. The optimal cut-off values of PPV and PVI were 7% (sensitivity 82%, specificity 62%) and 8% (sensitivity 67%, specificity 69%), respectively. Conclusion: Both PPV and PVI were able to predict fluid responsiveness; their predictive abilities were maintained in the prone position.
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/162607
Files in This Item:
T201801970.pdf Download
DOI
10.2147/tcrm.s170395
Appears in Collections:
1. Journal Papers (연구논문) > 1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실)
Yonsei Authors
김도형(Kim, Do Hyeong) ORCID logo https://orcid.org/0000-0003-2018-8090
김승현(Kim, Seung Hyun)
김지영(Kim, Ji Young) ORCID logo https://orcid.org/0000-0001-5822-0338
신서경(Shin, Seokyung) ORCID logo https://orcid.org/0000-0002-2641-0070
조민주(Jo, Minju)
최용선(Choi, Yong Seon) ORCID logo https://orcid.org/0000-0002-5348-864X
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