Prediction of fluid responsiveness in patients during cardiac surgery

Abstract

In patients after CABG surgery who were ventilated with low tidal volumes, SVV enabled prediction of fluid responsiveness and assessment of the haemodynamic effects of volume loading.

Pulse pressure variation and stroke volume variation predict fluid responsiveness in mechanically ventilated patients experiencing intra-abdominal hypertension

“…A more accurate method for preload assessment is based on the heartlung interactions and the measurement of PPV and SVV by arterial waveform analysis in mechanically ventilated patients. Many studies have demonstrated that PPV and SVV are highly sensitive in predicting fluid responsiveness in mechanically ventilated patients undergoing cardiac surgery, neurosurgical procedures, and live transplantation (7)(8)(9). However, some procedures utilize the insufflation of carbon dioxide, such as for minimal laparoscopic manipulations, which induce IAH.…”

“…Frequently used static preload variables such as central venous pressure (CVP) or pulmonary capillary wedge pressure often fail to provide reliable information on cardiac preload and are not capable of predicting a cardiac response to fluid therapy (5,6). As an alternative to these static variables, stroke volume variation (SVV) and pulse pressure variation (PPV) have been shown to be sensitive predictors of fluid responsiveness in mechanically ventilated patients undergoing cardiac surgery, neurosurgical procedures, and live transplantation (7)(8)(9). Left ventricle preload is highly susceptible to changes in the intrathoracic pressure induced by mechanical ventilation.…”

Year in review in journal of clinical monitoring and computing 2014: cardiovascular and hemodynamic monitoring

“…Functional hemodynamic monitoring has gained increasing popularity in the hemodynamic management of critically ill patients. It has been repeatedly demonstrated that-in contrast to static preload parameters (such as filling pressures or volumetric variables)-only dynamic preload indicators (mainly derived from respiratory variations of arterial pressure) can reliably predict fluid responsiveness [2]. However, for the intraoperative period, it has recently been reported that due to the prevalence of these limitations, monitoring of ventilation-induced pressure variations is only applicable in approximately 40 % of all patients undergoing surgery [3].…”

Pulse pressure variation to predict fluid responsiveness in spontaneously breathing patients: tidal vs forced inspiratory breathing

“…Static variables such as pulmonary artery occlusion pressure and central venous pressure are poor at predicting fluid responsiveness [3][4][5][6]. However, dynamic variables, such as systolic pressure variation, pulse pressure variation (PPV), and stoke volume variation can help optimise fluid management during mechanical ventilation [5,[7][8][9].…”