J Clin Monit Comput - Assessment of the effect of rapid crystalloid infusion on stroke volume variation and pleth variability index after a preoperative fast.

Tópicos

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Resumo

JECTIVE: Stroke volume variation (SVV) during controlled mechanical ventilation is a useful predictor in response to volume expansion, and pleth variability index (PVI), a novel algorithm allowing for automated and continuous calculation of the respiratory variations in the pulse oximeter waveform amplitude, can also predict fluid responsiveness non-invasively in mechanically ventilated patients. The aim of this study was (1) to determine whether acute fluid infusion affects SVV and PVI, and (2) to compare the two values in the case of acute fluid infusion after a preoperative fast following general anesthesia induction.METHODS: After tracheal intubation, the patients' lungs were mechanically ventilated. Subjects were anesthetized using sevoflurane and were given a rapid, constant-rate infusion of crystalloid (500?ml in 15?min). Systolic arterial pressure (SAP), diastolic arterial pressure (DAP), heart rate (HR), cardiac output (CO), cardiac index (CI), SVV, and PVI were measured at baseline and after 250 and 500?ml had been infused, and these values were compared.RESULTS: SAP, DAP, CO, and CI were unchanged after the infusion. HR and SVV decreased significantly after the infusion. SVI increased significantly after the infusion. There was a significant difference in PVI only between the post 250?ml and post 500?ml infusions.CONCLUSIONS: A rapid infusion of 250-500?ml of a crystalloid in nearly healthy subjects who had fasted overnight returned their SVV to within the normal range. In such cases, SVV is a more sensitive predictor of fluid responsiveness than is PVI, and the infusion gradually increased SVI.

Resumo Limpo

jectiv stroke volum variat svv control mechan ventil use predictor respons volum expans pleth variabl index pvi novel algorithm allow autom continu calcul respiratori variat puls oximet waveform amplitud can also predict fluid respons noninvas mechan ventil patient aim studi determin whether acut fluid infus affect svv pvi compar two valu case acut fluid infus preoper fast follow general anesthesia inductionmethod tracheal intub patient lung mechan ventil subject anesthet use sevofluran given rapid constantr infus crystalloid ml min systol arteri pressur sap diastol arteri pressur dap heart rate hr cardiac output co cardiac index ci svv pvi measur baselin ml infus valu comparedresult sap dap co ci unchang infus hr svv decreas signific infus svi increas signific infus signific differ pvi post ml post ml infusionsconclus rapid infus ml crystalloid near healthi subject fast overnight return svv within normal rang case svv sensit predictor fluid respons pvi infus gradual increas svi

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