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Effect of pulse pressure on the predictability of stroke volume variation for fluid responsiveness in patients with coronary disease

Authors
 So Yeon Kim  ;  Young Song  ;  Jae Kwang Shim  ;  Young Lan Kwak 
Citation
 JOURNAL OF CRITICAL CARE, Vol.28(3) : 318-7, 2013 
Journal Title
 JOURNAL OF CRITICAL CARE 
ISSN
 0883-9441 
Issue Date
2013
MeSH
Aged ; Area Under Curve ; Blood Pressure/physiology* ; Cardiac Catheterization ; Coronary Artery Bypass ; Coronary Disease/physiopathology ; Coronary Disease/surgery* ; Female ; Fluid Therapy* ; Humans ; Male ; Predictive Value of Tests ; ROC Curve ; Sensitivity and Specificity ; Stroke Volume/physiology*
Keywords
Fluid responsiveness ; Pulse contour analysis ; Pulse pressure ; Stroke volume index ; Stroke volume variation
Abstract
We hypothesized that the predictability of stroke volume variation (SVV) on fluid responsiveness would be reduced in patients with coronary disease who have wide pulse pressure (PP). METHODS: Sixty-six patients undergoing coronary surgery were divided into 2 groups according to the PP measured 1 day before surgery: normal PP (n = 33, PP ≤ 60 mm Hg) or wide PP (n = 33, PP > 60 mm Hg). After applying mechanical ventilation, hemodynamic parameters (including SVV measured by the FloTrac/Vigileo system [Edwards Lifesciences, Irvine, Calif]) were recorded before and 10 minutes after fluid replacement in a closed-chest condition. Prediction of fluid responsiveness was tested by calculating the area under the receiver operating characteristic curves. RESULTS: Twenty-one patients in the normal PP and 16 patients in the wide PP condition were fluid responders. The area under the receiver operating characteristic curves of SVV to predict fluid responsiveness were 0.808 (P = .022) and 0.609 (P = .288) in the normal PP and wide PP patients, respectively. In the normal PP condition, a SVV value of 13% discriminated between fluid responders and nonresponders with a sensitivity of 76% and a specificity of 67%. CONCLUSIONS: In contrast to patients with normal PP, SVV does not predict fluid responsiveness in patients with coronary disease who have wide PP.
Full Text
http://www.sciencedirect.com/science/article/pii/S0883944112003218
DOI
10.1016/j.jcrc.2012.09.011
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Kwak, Young Lan(곽영란) ORCID logo https://orcid.org/0000-0002-2984-9927
Kim, So Yeon(김소연) ORCID logo https://orcid.org/0000-0001-5352-157X
Song, Young(송영) ORCID logo https://orcid.org/0000-0003-4597-387X
Shim, Jae Kwang(심재광) ORCID logo https://orcid.org/0000-0001-9093-9692
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/87015
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