uu.seUppsala University Publications
Change search
ReferencesLink to record
Permanent link

Direct link
Automated pre-ejection period variation indexed to tidal volume predicts fluid responsiveness after cardiac surgery
Uppsala University, Disciplinary Domain of Medicine and Pharmacy, Faculty of Medicine, Department of Surgical Sciences, Anaesthesiology and Intensive Care.
2009 (English)In: Acta Anaesthesiologica Scandinavica, ISSN 0001-5172, E-ISSN 1399-6576, Vol. 53, no 4, 534-42 p.Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Reliable continuous monitoring of fluid responsiveness is an unsolved issue in patients ventilated with low tidal volume. We hypothesised that variations in the pre-ejection period (PEP) defined as the time interval between electrocardiogram (ECG) R-wave and onset of systolic upstroke in arterial blood pressure could reliably predict fluid responsiveness in patients ventilated with moderately low tidal volume. Furthermore, we hypothesised that indexing dynamic parameters to tidal volume would improve their prediction. The aim was to refine and automate a previously suggested algorithm for PEP variation (DeltaPEP) and to test this new parameter indexed to tidal volume (PEPV), as a marker of fluid responsiveness along with central venous pressure (CVP), pulse pressure variation (PPV) and DeltaPEP. Additionally, the aim was to evaluate the concept of indexing dynamic parameters to tidal volume. METHODS: Arterial pressure, CVP, ECG and cardiac index (CI) were acquired from 23 mechanically ventilated post-cardiac surgery patients scheduled for volume expansion. PEPV, PPV and DeltaPEP were extracted. RESULTS: Using responder/non-responder classification (response=change in CI>+15%), sensitivity and specificity were 100% and 83%, respectively, for PEPV, 94% and 83% for DeltaPEP, and 94% and 83% for PPV. CVP offered no relevant information. Tidal volume indexing improved sensitivity for DeltaPEP to 100%. CONCLUSION: In this study in post-cardiac surgery patients, a refined parameter, PEPV, predicted fluid responsiveness better than PPV and DeltaPEP. Our results suggest that dynamic parameters using variations in PEP should be indexed to tidal volume.

Place, publisher, year, edition, pages
2009. Vol. 53, no 4, 534-42 p.
National Category
Medical and Health Sciences
URN: urn:nbn:se:uu:diva-114158DOI: 10.1111/j.1399-6576.2008.01893.xPubMedID: 19239409OAI: oai:DiVA.org:uu-114158DiVA: diva2:293253
Available from: 2010-02-11 Created: 2010-02-11 Last updated: 2010-03-31Bibliographically approved

Open Access in DiVA

No full text

Other links

Publisher's full textPubMed
By organisation
Anaesthesiology and Intensive Care
In the same journal
Acta Anaesthesiologica Scandinavica
Medical and Health Sciences

Search outside of DiVA

GoogleGoogle Scholar

Altmetric score

Total: 145 hits
ReferencesLink to record
Permanent link

Direct link