Authors: D.A. Reuter; T.W. Felbinger; E. Kilger; C. Schmidt; P. Lamm; A.E. Goetz

Source: BJA: British Journal of Anaesthesia, Volume 88, Number 1, 1 January 2002 , pp. 124-126(3)

Publisher: Oxford University Press

Abstract:

Background. Mechanical ventilation causes changes in left ventricular preload leading to distinct variations in left ventricular stroke volume and systolic arterial pressure. Retrospective off-line quantification of systolic arterial pressure variations (SPV) has been validated as a sensitive method of predicting left ventricular response to volume administration. We report the real-time measurement of left ventricular stroke volume variations (SVV) by continuous arterial pulse contour analysis and compare it with off-line measurements of SPV in patients after cardiac surgery.

Methods. SVV and SPV were determined before and after volume loading with colloids in 20 mechanically ventilated patients.

Results. SVV and SPV decreased significantly after volume loading and were correlated (r=0.89; P<0.001). Changes in SVV and changes in SPV as a result of volume loading were also significantly correlated (r=0.85; P<0.005). Changes in SVV correlated significantly with changes in stroke volume index (SVI) (r=0.67; P<0.005) as did changes in SPV (r=0.56; P<0.05). SVV determined before volume loading correlated significantly with changes in SVI (R=0.67; P <0.005). Using receiver operating characteristics curves, the area under the curve was statistically greater for SVV (0.824; 95% confidence interval: [CI] 0.64–1.0) and SPV (0.81; CI: 0.62–1.0) than for central venous pressure (0.451; CI: 0.17–0.74).

Conclusions. Monitoring of SVV enables real-time prediction and monitoring of the left ventricular response to preload enhancement in patients after cardiac surgery and is helpful for guiding volume therapy.

Br J Anaesth 2002; 88: 124–6

Keywords: Keywords: heart, left ventricular preload; heart, left ventricular response; heart, systolic pressure variation; heart, central venous pressure; measurement techniques, pulse contour analysis; monitoring, haemodynamic

Document Type: Original article

Affiliations: 1: 1Department of Anaesthesiology and 2Department of Cardiac Surgery, Ludwig-Maximilians-University, Großhadern University Hospital, Marchioninistr. 15, D-81377 Munich, Germany*Corresponding author

Publication date: 2002-01-01

More about this publication?

• Founded in 1923, one year after the first anaesthetic journal was published by the International Anaesthesia Research Society, the British Journal of Anaesthesia remains the oldest and largest independent journal of anaesthesia. It became the journal of The College of Anaesthetists in 1990. The College was granted a Royal Charter in 1992. Although there are educational links between the BJA and the College, the journal retains editorial independence.

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