scholarly journals Evaluation of Fluid Responsiveness: Is Photoplethysmography a Noninvasive Alternative?

2012 ◽  
Vol 2012 ◽  
pp. 1-10 ◽  
Author(s):  
Lars Prag Antonsen ◽  
Knut Arvid Kirkebøen
Keyword(s):  
Fluid Responsiveness ◽  
Operating Characteristic ◽  
Current Data ◽  
Clinical Settings ◽  
Predict Fluid Responsiveness ◽  
Predictive Values ◽  
Receiver Operating Characteristic Curves ◽  
Hemodynamic Variables ◽  
Goal Directed Fluid Therapy ◽  
Dynamic Variables

Background. Goal-directed fluid therapy reduces morbidity and mortality in various clinical settings. Respiratory variations in photoplethysmography are proposed as a noninvasive alternative to predict fluid responsiveness during mechanical ventilation. This paper aims to critically evaluate current data on the ability of photoplethysmography to predict fluid responsiveness.Method. Primary searches were performed in PubMed, Medline, and Embase on November 10, 2011.Results. 14 papers evaluating photoplethysmography and fluid responsiveness were found. Nine studies calculated areas under the receiver operating characteristic curves forΔPOP (>0.85 in four, 0.75–0.85 in one, and <0.75 in four studies) and seven for PVI (values ranging from 0.54 to 0.98). Correlations betweenΔPOP/PVI andΔPP/other dynamic variables vary substantially.Conclusion. Although photoplethysmography is a promising technique, predictive values and correlations with other hemodynamic variables indicating fluid responsiveness vary substantially. Presently, it is not documented that photoplethysmography is adequately valid and reliable to be included in clinical practice for evaluation of fluid responsiveness.

scholarly journals An Increase in Aortic Blood Flow after an Infusion of 100 ml Colloid over 1 Minute Can Predict Fluid Responsiveness

2011 ◽  
Vol 115 (3) ◽  
pp. 541-547 ◽  
Author(s):  
Laurent Muller ◽  
Medhi Toumi ◽  
Philippe-Jean Bousquet ◽  
Béatrice Riu-Poulenc ◽  
Guillaume Louart ◽  
...  
Keyword(s):  
Receiver Operating Characteristic ◽  
Fluid Responsiveness ◽  
Pulse Pressure ◽  
Pulse Pressure Variation ◽  
Operating Characteristic ◽  
Venous Pressure ◽  
Pressure Variation ◽  
Characteristic Curves ◽  
Receiver Operating Characteristic Curves ◽  
Receiver Operating

Background Predicting fluid responsiveness remains a difficult question in hemodynamically unstable patients. The author's objective was to test whether noninvasive assessment by transthoracic echocardiography of subaortic velocity time index (VTI) variation after a low volume of fluid infusion (100 ml hydroxyethyl starch) can predict fluid responsiveness. Methods Thirty-nine critically ill ventilated and sedated patients with acute circulatory failure were prospectively studied. Subaortic VTI was measured by transthoracic echocardiography before fluid infusion (baseline), after 100 ml hydroxyethyl starch infusion over 1 min, and after an additional infusion of 400 ml hydroxyethyl starch over 14 min. The authors measured the variation of VTI after 100 ml fluid (ΔVTI 100) for each patient. Receiver operating characteristic curves were generated for (ΔVTI 100). When available, receiver operating characteristic curves also were generated for pulse pressure variation and central venous pressure. Results After 500 ml volume expansion, VTI increased ≥ 15% in 21 patients (54%) defined as responders. ΔVTI 100 ≥ 10% predicted fluid responsiveness with a sensitivity and specificity of 95% and 78%, respectively. The area under the receiver operating characteristic curves of ΔVTI 100 was 0.92 (95% CI: 0.78-0.98). In 29 patients, pulse pressure variation and central venous pressure also were available. In this subgroup of patients, the area under the receiver operating characteristic curves for ΔVTI 100, pulse pressure variation, and central venous pressure were 0.90 (95% CI: 0.74-0.98, P &lt; 0.05), 0.55 (95% CI: 0.35-0.73, NS), and 0.61 (95% CI: 0.41-0.79, NS), respectively. Conclusion In patients with low volume mechanical ventilation and acute circulatory failure, ΔVTI 100 accurately predicts fluid responsiveness.

Dynamic Variables Fail to Predict Fluid Responsiveness in an Animal Model With Pericardial Effusion

2016 ◽  
Vol 30 (5) ◽  
pp. 1205-1211 ◽  
Author(s):  
Ole Broch ◽  
Jochen Renner ◽  
Patrick Meybohm ◽  
Martin Albrecht ◽  
Jan Höcker ◽  
...  
Keyword(s):  
Animal Model ◽  
Pericardial Effusion ◽  
Fluid Responsiveness ◽  
Predict Fluid Responsiveness ◽  
Dynamic Variables

scholarly journals Predictive values of serum soluble CD40 ligand in acute appendicitis in children

2020 ◽  
Author(s):  
Wun-Yan Huang ◽  
En-Pei Lee ◽  
Yu-Jun Chang ◽  
Chieh-Chung Lin ◽  
Han-Ping Wu
Keyword(s):  
Operating Characteristic ◽  
Perforated Appendicitis ◽  
Cd40 Ligand ◽  
Soluble Cd40 Ligand ◽  
Predictive Values ◽  
Inflammatory Biomarker ◽  
Receiver Operating Characteristic Curves ◽  
Suspected Appendicitis ◽  
Abdominal Emergencies ◽  
Rule Out

Abstract Appendicitis is one of the most common abdominal emergencies in children. Clinicians cannot easily distinguish between non-perforated and perforated appendicitis in children through physical and laboratory tests. An abdominal computed tomography is a common tool for diagnosis. However, excessive radiation exposure is not suitable for children. Serum soluble CD40 ligand (sCD40L) is an inflammatory biomarker. The purpose of our study was to predict pediatric appendicitis and perforated appendicitis using sCD40L. All pediatric patients with suspected appendicitis were tested for serum sCD40L within 72 h of the symptom onset. sCD40L levels were compared between patients with a normal appendix, appendicitis, and a perforated appendicitis. The diagnostic performance of sCD40L was calculated, and receiver operating characteristic curves were drawn. Of 116 patients, 62 had non-perforated appendicitis, 44 had perforated appendicitis, and 10 had normal appendices. The sensitivity of sCD40L in predicting appendicitis was 1.00, while the specificity in predicting perforation was 1.00. The best cutoff point was found to be 178.00 pg/ml for predicting appendicitis and 308.26 pg/ml for perforation. SCD40L is an excellent predictor of pediatric appendicitis. sCD40L below 90.04 pg/ml can rule out appendicitis and above 301.00 pg/ml can rule in appendicitis.

scholarly journals Platelet Count to Spleen Diameter Ratio for the Diagnosis of Esophageal Varices: Is It Feasible?

2008 ◽  
Vol 22 (10) ◽  
pp. 825-828 ◽  
Author(s):  
Waqas Wahid Baig ◽  
MV Nagaraja ◽  
Muralidhar Varma ◽  
Ravindra Prabhu
Keyword(s):  
Liver Cirrhosis ◽  
Platelet Count ◽  
Receiver Operating Characteristic ◽  
Esophageal Varices ◽  
Operating Characteristic ◽  
Diameter Ratio ◽  
Characteristic Curves ◽  
Predictive Values ◽  
Receiver Operating Characteristic Curves ◽  
Receiver Operating

AIM: To study the value of platelet count to spleen diameter ratio as a noninvasive parameter for diagnosing esophageal varices (EVs) in liver cirrhosis.METHODS: The laboratory and ultrasonographic variables were prospectively evaluated in 150 patients with liver cirrhosis. Only stable patients were included in the study. Patients with active gastrointestinal bleeding at the time of admission were excluded. All patients underwent screening upper gastrointestinal endoscopy.RESULTS: The platelet count, spleen diameter and platelet count to spleen diameter ratio in patients with EVs were significantly different from patients without EVs. The platelet count to spleen diameter ratio had the highest accuracy among the three parameters. By applying receiver operating characteristic curves, a platelet count to spleen diameter ratio cut-off value of 1014 was obtained, which gave positive and negative predictive values of 95.4% and 95.1%, respectively. The accuracy of this cut-off value as evaluated by applying receiver operating characteristic curves was 0.942 (95% CI 0.890 to 0.995).CONCLUSION: Among the noninvasive parameters studied, platelet count to spleen diameter ratio had the highest accuracy for diagnosing EVs. However, the evidence for the noninvasive diagnosis is not yet sufficient to replace endoscopy as a diagnostic screening tool for EVs in all cirrhotic patients. The platelet count to spleen diameter ratio may be a useful tool for diagnosing EVs in liver cirrhosis noninvasively when endoscopy facilities are not available.

scholarly journals Evaluation of alpha-l-fucosidase for the diagnosis of hepatocellular carcinoma based on meta-analysis

2020 ◽  
Vol 0 (0) ◽  
Author(s):  
Lei Xi ◽  
Chunqing Yang
Keyword(s):  
Hepatocellular Carcinoma ◽  
Operating Characteristic ◽  
Meta Analysis ◽  
Area Under The Curve ◽  
Diagnostic Odds Ratio ◽  
Diagnostic Value ◽  
Receiver Operating Characteristic Curves ◽  
Sensitivity Specificity ◽  
Review Manager

AbstractObjectivesThe main aim of the present study was to assess the diagnostic value of alpha-l-fucosidase (AFU) for hepatocellular carcinoma (HCC).MethodsStudies that explored the diagnostic value of AFU in HCC were searched in EMBASE, SCI, and PUBMED. The sensitivity, specificity, and DOR about the accuracy of serum AFU in the diagnosis of HCC were pooled. The methodological quality of each article was evaluated with QUADAS-2 (quality assessment for studies of diagnostic accuracy 2). Receiver operating characteristic curves (ROC) analysis was performed. Statistical analysis was conducted by using Review Manager 5 and Open Meta-analyst.ResultsEighteen studies were selected in this study. The pooled estimates for AFU vs. α-fetoprotein (AFP) in the diagnosis of HCC in 18 studies were as follows: sensitivity of 0.7352 (0.6827, 0.7818) vs. 0.7501 (0.6725, 0.8144), and specificity of 0.7681 (0.6946, 0.8283) vs. 0.8208 (0.7586, 0.8697), diagnostic odds ratio (DOR) of 7.974(5.302, 11.993) vs. 13.401 (8.359, 21.483), area under the curve (AUC) of 0.7968 vs. 0.8451, respectively.ConclusionsAFU is comparable to AFP for the diagnosis of HCC.

A conditional approach for the receiver operating characteristic curve construction to evaluate diagnostic test performance in a family-matched case–control design

2021 ◽  
pp. 096228022199595
Author(s):  
Yalda Zarnegarnia ◽  
Shari Messinger
Keyword(s):  
Receiver Operating Characteristic Curve ◽  
Receiver Operating Characteristic ◽  
Operating Characteristic ◽  
Characteristic Curve ◽  
Case Control ◽  
Paired Data ◽  
Characteristic Curves ◽  
Receiver Operating Characteristic Curves ◽  
Operating Characteristic Curve ◽  
Receiver Operating

Receiver operating characteristic curves are widely used in medical research to illustrate biomarker performance in binary classification, particularly with respect to disease or health status. Study designs that include related subjects, such as siblings, usually have common environmental or genetic factors giving rise to correlated biomarker data. The design could be used to improve detection of biomarkers informative of increased risk, allowing initiation of treatment to stop or slow disease progression. Available methods for receiver operating characteristic construction do not take advantage of correlation inherent in this design to improve biomarker performance. This paper will briefly review some developed methods for receiver operating characteristic curve estimation in settings with correlated data from case–control designs and will discuss the limitations of current methods for analyzing correlated familial paired data. An alternative approach using conditional receiver operating characteristic curves will be demonstrated. The proposed approach will use information about correlation among biomarker values, producing conditional receiver operating characteristic curves that evaluate the ability of a biomarker to discriminate between affected and unaffected subjects in a familial paired design.

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