• Evgenia V Fot, Natalia N Izotova, Aleksei A Smetkin, Vsevolod V Kuzkov, and Mikhail Y Kirov.
• Department of Anesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russian Federation. Electronic address: ev_fot@mail.ru.
• J. Cardiothorac. Vasc. Anesth. 2020 Apr 1; 34 (4): 926-931.

ObjectiveTo test the hypothesis that a positive end-expiratory pressure test and the mini-fluid challenge predict fluid responsiveness in patients after off-pump coronary artery bypass grafting.DesignSingle-center pilot prospective observational study.SettingCity Hospital #1 of Arkhangelsk, Russian Federation.ParticipantsThirty-two adult patients after off-pump coronary artery surgery.InterventionsTo assess fluid responsiveness, after arrival to the intensive care unit, all patients received a test with increase in positive end-expiratory pressure from 5 to 20 cmH2O for 2 minutes, a mini-fluid challenge test with administration of crystalloids at 1.5 mL/kg during 2 minutes, and standard fluid challenge test using 7 mL/kg during 10 minutes.Measurements And Main ResultsThe patients with an increase in cardiac index by ≥15% after a standard fluid challenge test were defined as fluid responders. According to receiver operating characteristic analysis, a decrease in mean arterial pressure exceeding 5 mmHg in 120 seconds of the positive end-expiratory pressure test identified fluid responsiveness with an area under the curve of 0.73 (p = 0.03). The reduction in pulse pressure and stroke volume variations by more than 2% during mini-fluid challenge test predicted positive response to fluid load with an area under the curve of 0.77 and 0.75, respectively (p < 0.05).ConclusionBoth the positive end-expiratory pressure test and the mini-fluid challenge test are feasible after off-pump coronary artery bypass grafting and can be used to predict fluid responsiveness in these patients.Copyright © 2019 Elsevier Inc. All rights reserved.

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