Assessment of fluid responsiveness in mechanically ventilated cardiac surgical patients

Wiesenack, Christoph; Fiegl, Christoph; Keyser, Andreas; Prasser, Christopher; Keyl, Cornelius

doi:10.1017/s0265021505001092

Cited by 131 publications

(80 citation statements)

References 31 publications

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“…In this review, we adopted the modified 19-point STARD score to judge the quality of the investigation in the selected studies (Table 1). Each criterion was assigned one point and the overall score divided into categories: poor (score 0-10), adequate (11)(12)(13)(14)(15) and good (16)(17)(18)(19). The results of the selected studies were not metaanalysed due to the heterogeneity in methodologies, patient populations, modes of mechanical ventilation, definitions of fluid responsiveness and volume of fluid challenges given.…”

Section: Methodsmentioning

confidence: 99%

Physiological controversies and methods used to determine fluid responsiveness: a qualitative systematic review

et al. 2015

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SummaryAccurate assessment of intravascular fluid status and measurement of fluid responsiveness have become increasingly important in peri-operative medicine and critical care. The objectives of this systematic review and narrative synthesis were to discuss current controversies surrounding fluid responsiveness and describe the merits and limitations of the major cardiac output monitors in clinical use today in terms of usefulness in measuring fluid responsiveness. We searched the MEDLINE and EMBASE databases (2002)(2003)(2004)(2005)(2006)(2007)(2008)(2009)(2010)(2011)(2012)(2013)(2014)(2015); inclusion criteria included comparison with an established reference standard such as pulmonary artery catheter, transthoracic echocardiography and transoesophageal echocardiography. Examples of clinical measures include static (such as central venous pressure) and dynamic (such as stroke volume variation and pulse pressure variation) parameters. The static parameters measured were described as having little value; however, the dynamic parameters were shown to be good physiological determinants of fluid responsiveness. Due to heterogeneity of the methods and patient characteristics, we did not perform a meta-analysis. In most studies, precision and limits of agreement (bias AE1.96SD) between determinants of fluid responsiveness measured by different devices were not evaluated, and the definition of fluid responsiveness varied across studies. Future research should focus on the physiological principles that underlie the measurement of fluid responsiveness and the effect of different volume expansion strategies on outcomes.

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Section: Methodsmentioning

confidence: 99%

Physiological controversies and methods used to determine fluid responsiveness: a qualitative systematic review

et al. 2015

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“…In the past decades, it has been shown that static indices such as CVP, PCWP, left ventricular end diastolic area, and right ventricular end-diastolic volume are not accurate for the prediction of fluid responsiveness [13,[47][48][49][50][51]. In contrast, several studies have shown that dynamic indices, such as SVV and PPV, are able to predict fluid responsiveness accurately [52][53][54][55][56].…”

Section: Pulse Contour Analysismentioning

confidence: 99%

Guiding Goal-Directed Therapy

Suehiro

Joosten

Alexander

2014

Curr Anesthesiol Rep

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Several studies have demonstrated that perioperative hemodynamic optimization (or ''goal directed therapy'') using minimally invasive hemodynamic monitoring technologies has the ability to improve postoperative patients' outcome with lower complication rates, shorter hospital lengths of stay, and lower cost of surgery. This specific concept of goal-directed therapy (GDT) uses perioperative cardiac output monitoring and manipulation of physiologic parameters (dynamic parameters of fluid responsiveness) to guide intravenous fluids and inotropic therapy with the goal of ensuring adequate tissue perfusion. Recently, the evidence related to the implementation of GDT strategies has been considered strong enough to allow for the creation of national recommendations in the UK, in France, and by the European Society of Anaesthesiology. The aims of the programs are to apply best practices to high-risk surgical patients and requires the participation of all clinicians involved in patients' care. Considering the potential clinical and economic benefits of GDT protocols and the positive recommendations from influential scientific societies, more and more hospitals around the world have become interested in implementing hemodynamic optimization in their departments. This review provides the information about the evolution of hemodynamic monitoring from invasive to the more recent noninvasive devices, and how these devices can be used in the operating rooms through well-defined algorithms of GDT.

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“…연속적 자동 맥압변이의 안전성 및 유효성 평가에 선택된 문헌은 총 20편으로 연구유형은 모두 진단법 평가연구였다 (Table 3) [6][7][8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24][25]. [정리: 편집위원회]…”

Section: 체계적 문헌고찰 및 메타분석 결과unclassified

Continuous automatic pulse pressure variation: a systematic review and meta-analysis

Bang

2015

J Korean Med Assoc

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The continuous automatic pulse pressure variation (PPVauto) is a test that continuously and automatically measures the pulse pressure of the patients who need fluid therapy among the general anesthesia patients or artificial respiration patients for whom voluntary breathing is impossible during surgical procedure. The objective of this review is to evaluate the safety and effectiveness of PPVauto. The searches were conducted on eight Korean databases including KoreaMed, Medline, Embase, and Cochrane Library. Seven hundred thirty-seven literatures were searched, and total of 20 studies were included for this review. On the basis of current data, we recommend that PPVauto is safe and effective test for patients who need fluid therapy among the general anesthesia patients or artificial respiration patients for whom voluntary breathing is impossible during surgical procedure.

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Assessment of fluid responsiveness in mechanically ventilated cardiac surgical patients

Cited by 131 publications

References 31 publications

Physiological controversies and methods used to determine fluid responsiveness: a qualitative systematic review

Physiological controversies and methods used to determine fluid responsiveness: a qualitative systematic review

Guiding Goal-Directed Therapy

Continuous automatic pulse pressure variation: a systematic review and meta-analysis

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