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CARDIOVASCULAR ANESTHESIA

Stroke Volume Variation as an Indicator of Fluid Responsiveness Using Pulse Contour Analysis in Mechanically Ventilated Patients

Department of Anesthesia, University Hospital, Regensburg, Germany

Address correspondence and reprint requests to Christoph Wiesenack, MD, University Hospital, Department of Anesthesia, Franz-Josef-Strauss Allee 11, 93052 Regensburg, Germany. Address e-mail to christoph.wiesenack{at}klinik.uni-regensburg.de

Assessment of cardiac performance and adequate fluid replacement of a critically ill patient are important goals of a clinician. We designed this study to evaluate the ability of stroke volume variation (SVV), derived from pulse contour analysis, and frequently used preload variables (central venous pressure and pulmonary capillary wedge pressure) to predict the response of stroke volume index and cardiac index to volume replacement in normoventilated cardiac surgical patients. We studied 20 patients undergoing elective coronary artery bypass grafting. After the induction of anesthesia, hemodynamic measurements were performed before (T1) and subsequent to volume replacement by infusion of 6% hydroxyethyl starch 200/0.5 (7 mL/kg) with a rate of 1 mL · kg^-1 · min^-1. Except for heart rate, all hemodynamic variables changed significantly (P < 0.01) after volume loading. Linear regression analysis between SVV at baseline (T1) and SVV after volume application showed a significant correlation (r = -0.97; P < 0.01), whereas linear regression analysis between SVV (T1) and percentage changes of stroke volume index (r = 0.19) and cardiac index (r = 0.17) did not reveal a significant relationship between variables. The results of our study suggest that SVV derived from pulse contour analysis cannot serve as an indicator of fluid responsiveness in normoventilated cardiac surgical patients.

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