• Jae-Kwang Shim, Jong-Wook Song, Young Song, Ji-Ho Kim, Hye-Min Kang, and Young-Lan Kwak.
• Department of Anesthesiology and Pain Medicine, Yonsei University Health System, Seoul, 120-752, South Korea; Anesthesia and Pain Research Institute, Yonsei University Health System, Seoul, 120-752, South Korea.
• J Crit Care. 2014 Dec 1;29(6):987-91.

PurposeThe purpose of this study was to test the hypothesis that the predictive ability of pulse pressure variation (PPV) for fluid responsiveness would be altered in patients with elevated left ventricular (LV) filling pressure.Materials And MethodsAccording to the preoperative echocardiographic assessment of the ratio of early transmitral flow velocity to early diastolic velocity of the mitral annulus (E/E'), patients undergoing surgical coronary revascularization were classified into normal (n=34, E/E'<8) and high (n=34, E/E'>15) LV filling pressure group. After anesthetic induction, PPV and hemodynamic data were measured before and after 6 mL/kg of colloid administration. Fluid responsiveness was defined as 12% or more increase in stroke volume index assessed by pulmonary artery catheter and tested by the area under the receiver operating characteristic curve (AUROC).ResultsThe AUROCs of PPV in the normal and high filling pressure group were 0.829 (95% confidence interval [CI], 0.661-0.963; P<.001) and 0.583 (95% CI, 0.402-0.749; P=.110), respectively. The AUROCs of cardiac filling pressures and right ventricular end-diastolic volume index did not show statistical significance in both groups.ConclusionsNone of the assessed preload indices including PPV were able to predict fluid responsiveness in patients with elevated LV filling pressure.Copyright © 2014 Elsevier Inc. All rights reserved.

26 keywords...

hide…