Functional haemodynamic monitoring: The value of SVV as measured by the LiDCORapid™ in predicting fluid responsiveness in high risk vascular surgical patients

Willars, Chris; Dada, A.; Hughes, Tim M.; Green, D.

doi:10.1016/j.ijsu.2012.02.003

Cited by 31 publications

(17 citation statements)

References 42 publications

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“…It is important to remember that the phasic signal detected from a cardiopulmonary interaction is a function of the intensity of the tidal volume and ITP change, of the method used to track a respirophasic SV change [53] and of the degree of hypovolemia (relative or absolute). In addition, one cannot assume that exaggerated cardio-pulmonary interaction is synonymous with fluid responsiveness and/or hypovelemia.…”

Section: Arterial Side or Stroke Volume Based Methodsmentioning

confidence: 99%

Cardiopulmonary interactions and volume status assessment

Broccard

2012

J Clin Monit Comput

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Assessment of the hemodynamics and volume status is an important daily task for physicians caring for critically ill patients. There is growing consensus in the critical care community that the "traditional" methods-e.g., central venous pressure or pulmonary artery occlusion pressure-used to assess volume status and fluid responsiveness are not well supported by evidence and can be misleading. Our purpose is to provide here an overview of the knowledge needed by ICU physicians to take advantage of mechanical cardiopulmonary interactions to assess volume responsiveness. Although not perfect, such dynamic assessment of fluid responsiveness can be helpful particularly in the passively ventilated patients. We discuss the impact of phasic changes in lung volume and intrathoracic pressure on the pulmonary and systemic circulation and on the heart function. We review how respirophasic changes on the venous side (great veins geometry) and arterial side (e.g., stroke volume/systolic blood pressure and surrogate signals) can be used to detect fluid responsiveness or hemodynamic alterations commonly encountered in the ICU. We review the physiological limitations of this approach.

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Section: Arterial Side or Stroke Volume Based Methodsmentioning

confidence: 99%

Cardiopulmonary interactions and volume status assessment

Broccard

2012

J Clin Monit Comput

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“…Despite the initial enthusiastic approach, LiDCOrapid failed to demonstrate a good correlation for SV values when compared with the PiCCO pulse contour [64] or transesophageal Doppler [65]. Regarding the ability of the LiDCOrapid-SVV to predict the fluid responsiveness, some studies performed in high risk vascular surgery [66] and in cardiac surgery [67] confirmed that this parameter is an adequate predictor of the CO response to fluid administration. LiDCOrapid was never used in GDT protocols in cardiac surgery but in obstetrics where the main advantages were less maternal hypotension and much less neonatal hypercapnia and hypoxemia in the GDT group than in the control group [68].…”

Section: Lidcorapid (Lidco Ltd Cambridge Uk)mentioning

confidence: 99%

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

Hendy

Bubenek

2016

Rom J Anaesth Int Care

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Hemodynamic monitoring has evolved and improved greatly during the past decades as the medical approach has shifted from a static to a functional approach. The technological advances have led to innovating calibrated or not, but minimally invasive and noninvasive devices based on arterial pressure waveform (APW) analysis. This systematic clinical review outlines the physiologic rationale behind these recent technologies. We describe the strengths and the limitations of each method in terms of accuracy and precision of measuring the flow parameters (stroke volume, cardiac output) and dynamic parameters which predict the fluid responsiveness. We also analyzed the place of the APW monitoring devices in goaldirected therapy (GDT) protocols in cardiac surgical patients. According to the data from the three GDTrandomized control trials performed in cardiac surgery (using two types of APW techniques PiCCO and FloTrac/Vigileo), these devices did not demonstrate that they played a role in decreasing mortality, but only decreasing the ventilation time and the ICU and hospital length of stay.

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“…SVV has been shown to be an adequate predictor of fluid responsiveness in various studies [40]. ΔVTI has been compared with Vigileo (Edwards Lifesciences, Irvine, USA) derived SVV with similar performance in a setting of liver transplantation and vasopressor support [4], though with normal systemic vascular resistance.…”

Section: Mechanical Ventilator Induced Intra-thoracic Pressure Changementioning

confidence: 99%

Assessment of loading conditions with cardiac ultrasound. A comprehensive review

Poelaert¹

2015

Anaesthesiol Intensive Ther

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Optimization of the preloading conditions and concomitant determination of endpoints of fluid administration are the most frequent therapeutic actions in critically ill patients. Besides a clinical appraisal, reproducible data should be acquired at the bedside to estimate the adequacy of fluid resuscitation. The dynamic assessment and determination of fluid responsiveness plays a major role in this respect. Right-sided cardiac variables, such as inferior and superior caval vein diameter variation during mechanical ventilation, are easily obtained with cardiac ultrasound. Moreover, left sided variables, including aortic flow variation, with intermittent swings of intrathoracic pressure during mechanical ventilation, may be achieved non-invasively with Doppler-echocardiography. Both in terms of resuscitation, as well as correct interpretation of various two-dimensional and Doppler variables, it is essential to acquire a clear understanding of the filling status of a patient. Doppler-echocardiography plays herein a pivotal role.

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Functional haemodynamic monitoring: The value of SVV as measured by the LiDCORapid™ in predicting fluid responsiveness in high risk vascular surgical patients

Cited by 31 publications

References 42 publications

Cardiopulmonary interactions and volume status assessment

Cardiopulmonary interactions and volume status assessment

Pulse waveform hemodynamic monitoring devices: recent advances and the place in goal-directed therapy in cardiac surgical patients

Assessment of loading conditions with cardiac ultrasound. A comprehensive review

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