Hemodynamic Changes via the Lung Recruitment Maneuver Can Predict Fluid Responsiveness in Stroke Volume and Arterial Pressure During One-Lung Ventilation

2021 ◽  
pp. 1
Author(s):  
Aya Kimura ◽  
Koichi Suehiro ◽  
Takashi Juri ◽  
Yohei Fujimoto ◽  
Hisako Yoshida ◽  
...  
Keyword(s):  
Arterial Pressure ◽  
Stroke Volume ◽  
Fluid Responsiveness ◽  
Recruitment Maneuver ◽  
Lung Ventilation ◽  
Lung Recruitment ◽  
Hemodynamic Changes ◽  
One Lung Ventilation ◽  
Predict Fluid Responsiveness ◽  
Lung Recruitment Maneuver

scholarly journals Diagnosis Accuracy of Mean Arterial Pressure Variation during a Lung Recruitment Maneuver to Predict Fluid Responsiveness in Thoracic Surgery with One-Lung Ventilation

2016 ◽  
Vol 2016 ◽  
pp. 1-8
Author(s):  
Woon-Seok Kang ◽  
Chung-Sik Oh ◽  
Chulmin Park ◽  
Bo Mi Shin ◽  
Tae-Gyoon Yoon ◽  
...  
Keyword(s):  
Blood Pressure ◽  
Thoracic Surgery ◽  
Fluid Responsiveness ◽  
Recruitment Maneuver ◽  
Lung Ventilation ◽  
Systemic Blood Pressure ◽  
One Lung Ventilation ◽  
Predict Fluid Responsiveness ◽  
Systemic Blood ◽  
Lung Recruitment Maneuver

Background. Lung recruitment maneuver (LRM) during thoracic surgery can reduce systemic venous return and resulting drop in systemic blood pressure depends on the patient’s fluid status. We hypothesized that changes in systemic blood pressure during the transition in LRM from one-lung ventilation (OLV) to two-lung ventilation (TLV) may provide an index to predict fluid responsiveness.Methods. Hemodynamic parameters were measured before LRM (T0); after LRM at the time of the lowest mean arterial blood pressure (MAP) (T1) and at 3 minutes (T2); before fluid administration (T3); and 5 minutes after ending it (T4). If the stroke volume index increased by >25% following 10 mL/kg colloid administration for 30 minutes, then the patients were assigned to responder group.Results. Changes in MAP, central venous pressure (CVP), and stroke volume variation (SVV) betweenT0andT1were significantly larger in responders. Areas under the curve for change in MAP, CVP, and SVV were 0.852, 0.759, and 0.820, respectively; the optimal threshold values for distinguishment of responders were 9.5 mmHg, 0.5 mmHg, and 3.5%, respectively.Conclusions. The change in the MAP associated with LRM at the OLV to TLV conversion appears to be a useful indicator of fluid responsiveness after thoracic surgery. Trial Registration. This trial is registered at Clinical Research Information Service withKCT0000774.

scholarly journals Dynamic Indices Fail to Predict Fluid Responsiveness in Patients Undergoing One-Lung Ventilation for Thoracoscopic Surgery

2021 ◽  
Vol 10 (11) ◽  
pp. 2335
Author(s):  
Kwanhoon Choi ◽  
Jae-Kwang Shim ◽  
Dong-Wook Kim ◽  
Chun-Sung Byun ◽  
Ji-Hyoung Park
Keyword(s):  
Confidence Interval ◽  
Stroke Volume ◽  
Fluid Responsiveness ◽  
Thoracoscopic Surgery ◽  
Lung Ventilation ◽  
Volume Index ◽  
One Lung Ventilation ◽  
Predict Fluid Responsiveness ◽  
Left Lateral Decubitus Position ◽  
The Right

Thoracic surgery using CO2 insufflation maintains closed-chest one-lung ventilation (OLV) that may provide the necessary heart–lung interaction for the dynamic indices to predict fluid responsiveness. We studied whether pulse pressure variation (PPV) and stroke volume variation (SVV) can predict fluid responsiveness during thoracoscopic surgery. Forty patients were enrolled in the study. OLV was performed with a tidal volume of 6 mL/kg at a positive end-expiratory pressure of 5 cm H2O, while CO2 was insufflated to the contralateral side at 8 mm Hg. Patients whose stroke volume index (SVI) increased ≥15% after fluid challenge (7 mL/kg) were defined as fluid responders. The predictive ability of PPV and SVV on fluid responsiveness was investigated using the area under the receiver-operator characteristic curve (AUROC), which was also assessed according to the right or left lateral decubitus position considering the intrathoracic location of the right-sided superior vena cava. AUROCs of PPV and SVV for predicting fluid responsiveness were 0.65 (95% confidence interval 0.47–0.83, p = 0.113) and 0.64 (95% confidence interval 0.45–0.82, p = 0.147), respectively. The AUROCs of indices did not exhibit any statistical significance according to position. Dynamic indices of preload cannot predict fluid responsiveness during one-lung ventilation with CO2 gas insufflation.

scholarly journals Stroke volume changes induced by a recruitment maneuver predict fluid responsiveness in patients with protective ventilation in the operating theater

Medicine ◽  
2016 ◽  
Vol 95 (28) ◽  
pp. e4259 ◽  
Author(s):  
Bruno De Broca ◽  
Jeremie Garnier ◽  
Marc-Olivier Fischer ◽  
Thomas Archange ◽  
Julien Marc ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Fluid Responsiveness ◽  
Recruitment Maneuver ◽  
Protective Ventilation ◽  
Volume Changes ◽  
Predict Fluid Responsiveness ◽  
Operating Theater

scholarly journals Ability of dynamic preload indices to predict fluid responsiveness in a high femoral-to-radial arterial pressure gradient: a retrospective study

2021 ◽  
Author(s):  
Seon Ju Kim ◽  
So Yeon Kim ◽  
Hye Sun Lee ◽  
Goeun Park ◽  
Eun Jang Yoon ◽  
...  
Keyword(s):  
Liver Disease ◽  
Arterial Pressure ◽  
Stroke Volume ◽  
Pressure Gradient ◽  
Fluid Responsiveness ◽  
Volume Index ◽  
Predict Fluid Responsiveness ◽  
End Stage Liver Disease ◽  
Vascular Compliance ◽  
End Stage

Background: Dynamic preload indices may predict fluid responsiveness in end-stage liver disease. However, their usefulness in patients with altered vascular compliance is uncertain. This study is the first to evaluate whether dynamic indices can reliably predict fluid responsiveness in patients undergoing liver transplantation with a high femoral-to-radial arterial pressure gradient (PG).Methods: 80 liver transplant recipients were retrospectively categorized as having a normal (n = 56) or high (n = 24, difference in systolic pressure ≥ 10 mmHg and/or mean pressure ≥ 5 mmHg) femoral-to-radial arterial PG, measured immediately after radial and femoral arterial cannulation. The ability of dynamic preload indices (stroke volume variation, pulse pressure variation [PPV], pleth variability index) to predict fluid responsiveness was assessed before the surgery. Fluid replacement of 500 ml of crystalloid solution was performed over 15 min. Fluid responsiveness was defined as ≥ 15% increase in the stroke volume index. The area under the receiver-operating characteristic curve (AUC) indicated the prediction of fluid responsiveness.Results: Fourteen patients in the normal, and eight in the high PG group were fluid responders. The AUCs for PPV in the normal, high PG groups and total patients were 0.702 (95% confidence interval [CI] 0.553–0.851, P = 0.008), 0.633 (95% CI 0.384–0.881, P = 0.295) and 0.667 (95% CI 0.537–0.798, P = 0.012), respectively. No other index predicted fluid responsiveness.Conclusion: PPV can be used as a dynamic index of fluid responsiveness in patients with end-stage liver disease but not in patients with altered vascular compliance.

scholarly journals Changes in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ryota Watanabe ◽  
Koichi Suehiro ◽  
Akira Mukai ◽  
Katsuaki Tanaka ◽  
Tokuhiro Yamada ◽  
...  
Keyword(s):  
Stroke Volume ◽  
Prone Position ◽  
Recruitment Maneuver ◽  
Protective Ventilation ◽  
Lung Recruitment ◽  
Lung Protective Ventilation ◽  
Future Research ◽  
Gray Zone ◽  
Clinical Trial Registry ◽  
Lung Recruitment Maneuver

Abstract Background The present study aimed to evaluate the reliability of hemodynamic changes induced by lung recruitment maneuver (LRM) in predicting stroke volume (SV) increase after fluid loading (FL) in prone position. Methods Thirty patients undergoing spine surgery in prone position were enrolled. Lung-protective ventilation (tidal volume, 6–7 mL/kg; positive end-expiratory pressure, 5 cmH2O) was provided to all patients. LRM (30 cmH2O for 30 s) was performed. Hemodynamic variables including mean arterial pressure (MAP), heart rate, SV, SV variation (SVV), and pulse pressure variation (PPV) were simultaneously recorded before, during, and at 5 min after LRM and after FL (250 mL in 10 min). Receiver operating characteristic curves were generated to evaluate the predictability of SVV, PPV, and SV decrease by LRM (ΔSVLRM) for SV responders (SV increase after FL > 10%). The gray zone approach was applied for ΔSVLRM. Results Areas under the curve (AUCs) for ΔSVLRM, SVV, and PPV to predict SV responders were 0.778 (95% confidence interval: 0.590–0.909), 0.563 (0.371–0.743), and 0.502 (0.315–0.689), respectively. The optimal threshold for ΔSVLRM was 30% (sensitivity, 92.3%; specificity, 70.6%). With the gray zone approach, the inconclusive values ranged 25 to 75% for ΔSVLRM (including 50% of enrolled patients). Conclusion In prone position, LRM-induced SV decrease predicted SV increase after FL with higher reliability than traditional dynamic indices. On the other hand, considering the relatively large gray zone in this study, future research is needed to further improve the clinical significance. Trial registration UMIN Clinical Trial Registry UMIN000027966. Registered 28th June 2017.

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