Comparison of Initial Distribution Volume of Glucose and Intrathoracic Blood Volume During Hemodynamically Unstable States Early After Esophagectomy

Assessment of cardiac preload status by pulse pressure variation in patients after anesthesia induction: comparison with central venous pressure and initial distribution volume of glucose

“…Recent findings have showed IDVG to be highly correlated with either cardiac output [32] or intrathoracic blood volume (ITBV) [33] in clinical and experimental studies. Although not widely accepted, IDVG has been reported to predict postoperative hypovolemia hypotension in patients undergoing abdominal aortic surgery [4] and esophagectomy [3,34], but not cardiac surgery [35]. This disparity in results may come from a different understanding of IDVG but is not attributable to methodological flaws of IDVG determination [36].…”

Neither dynamic, static, nor volumetric variables can accurately predict fluid responsiveness early after abdominothoracic esophagectomy

“…However, as this measurement was made in the presence of spontaneous respiratory activity (pressure support ventilation), it would be of limited use in evaluating fluid responsiveness. Abdominothoracic esophagectomy can lead to hemodynamic instability soon after the operation [8] and may also modify the original thoracic structure, decreasing the constraints of the chest wall imposed on the heart and the lungs and altering cyclic changes in intrathoracic pressure on heart-lung interactions. We therefore hypothesized that studies into fluid responsiveness would be of limited value during such hemodynamically unstable states.…”

“…Measurements can also be repeated at 30-min intervals without sustained increases in plasma glucose [12]. We previously reported that IDVG, rather than intrathoracic blood volume (ITBV) or central venous pressure (CVP), is closely correlated with cardiac output (CO) during hypotension and subsequent fluid volume loading early after esophagectomy [8]. Moreover, IDVG was recently reported to predict hypovolemic hypotension early after abdominal aortic surgery [13] and to have an inverse correlation with PPV after the induction of anesthesia in neurosurgical patients [14].…”

Use of initial distribution volume of glucose to determine fluid volume loading in pulmonary thromboembolism and right ventricular myocardial infarction

“…In the management of this patient we evaluated fl uid volume status by measuring the initial distribution volume of glucose (IDVG). IDVG has been reported to indicate central extracellular fl uid (ECF) volume without modifi cation of glucose metabolism and peripheral fl uid accumulation [1,2], and to display good linear correlation with cardiac output (CO) during hypovolemia and subsequent fl uid volume loading [3]. IDVG has potential to act as an indirect marker of cardiac preload, even though the concept of dilution volumetry is different from that of cardiac preload, namely, ventricular end-diastolic volume, and IDVG is not proportionally larger than cardiac preload.…”