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Titel:

Applicability of stroke volume variation in patients of a general intensive care unit: a longitudinal observational study.

Dokumenttyp:
Journal Article; 6
Autor(en):
Mair, Sebastian; Tschirdewahn, Julia; Götz, Simon; Frank, Johanna; Phillip, Veit; Henschel, Benedikt; Schultheiss, Caroline; Mayr, Ulrich; Noe, Sebastian; Treiber, Matthias; Schmid, Roland M; Saugel, Bernd; Huber, Wolfgang
Abstract:
Sinus rhythm (SR) and controlled mechanical ventilation (CV) are mandatory for the applicability of respiratory changes of the arterial curve such as stroke volume variation (SVV) to predict fluid-responsiveness. Furthermore, several secondary limitations including tidal volumes <8 mL/kg and SVV-values within the "gray zone" of 9-13% impair prediction of fluid-responsiveness by SVV. Therefore, we investigated the prevalence of these four conditions in general ICU-patients. This longitudinal observational study analyzed a prospectively maintained haemodynamic database including 4801 transpulmonary thermodilution and pulse contour analysis measurements of 278 patients (APACHE-II 21.0 ± 7.4). The main underlying diseases were cirrhosis (32%), sepsis (28%), and ARDS (17%). The prevalence of SR and CV was only 19.4% (54/278) in the first measurements (primary endpoint), 18.8% (902/4801) in all measurements and 26.5% (9/34) in measurements with MAP < 65 mmHg and CI < 2.5 L/min/m and vasopressor therapy. In 69.1% (192/278) of the first measurements and in 65.9% (3165/4801) of all measurements the patients had SR but did not have CV. In 1.8% (5/278) of the first measurements and in 2.5% (119/4801) of all measurements the patients had CV but lacked SR. In 9.7% (27/278) of the first measurements and in 12.8% (615/4801) of all measurements the patients did neither have SR nor CV. Only 20 of 278 (7.2%) of the first measurements and 8.2% of all measurements fulfilled both major criteria (CV, SR) and both minor criteria for the applicability of SVV. The applicability of SVV in ICU-patients is limited due to the absence of mandatory criteria during the majority of measurements.
Zeitschriftentitel:
J Clin Monit Comput
Jahr:
2017
Band / Volume:
31
Heft / Issue:
6
Seitenangaben Beitrag:
1177-1187
Sprache:
eng
Volltext / DOI:
doi:10.1007/s10877-016-9951-4
PubMed:
http://view.ncbi.nlm.nih.gov/pubmed/27817009
Print-ISSN:
1387-1307
TUM Einrichtung:
II. Medizinische Klinik und Poliklinik (Gastroenterologie)
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