Original articlePulse Pressure Variation Predicts Fluid Responsiveness in Elderly Patients After Coronary Artery Bypass Graft Surgery
Section snippets
Methods
This prospective interventional study was approved by the institutional review board and all patients gave an informed written consent. From January 2010 to February 2011, 68 consecutive patients >70 years old and admitted to the intensive care unit (ICU) after elective CABG surgery under cardiopulmonary bypass were eligible for the study. Eight patients were excluded subsequently because of a left ventricular ejection fraction ≤40%, intracardiac shunting, valvular heart disease, a pulmonary
Results
Sixty patients were included in this study. Forty-one patients were classified as fluid responders and 19 patients were classified as nonresponders (SVI increase after volume expansion 34 ± 8% v 4.6 ± 2%, p = 0.001). Patients' demographic, medical, and surgical data in the responder and nonresponder groups are presented in Table 1. The 2 groups were comparable for all the recorded data. Hemodynamic measurements at baseline (T0) and after volume expansion (T1) are presented in Table 2. Mean
Discussion
This study showed that the PPV during controlled mechanical ventilation predicts fluid responsiveness in patients >70 years old after CABG. The positive correlation between baseline values of PPV and the percent changes in SVI after volume expansion and between the area under the ROC curve and the threshold PPV value of 11.5% were similar to the data reported in younger patients undergoing cardiac surgery.5, 6, 7, 8, 9, 10 The ability of PPV to discriminate between fluid responders and
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2014, Journal of Cardiothoracic and Vascular AnesthesiaCitation Excerpt :Variables based on heart-lung interaction have been an attractive way to predict fluid responsiveness. Already described a half century ago,26 mechanical ventilator–induced stroke-volume variation (SVV) and pulse-pressure variation (PPV) have been reported to be reliable predictors of fluid responsiveness in different clinical settings (Table 2).22,23,25,43,53,68–75 These dynamic parameters have been increasingly-employed in the operating room and intensive care, especially because more physicians use pulse contour methods that not only allow CO measurements but also obtain SVV and PPV.46
Use of Pulse Pressure Variation as Predictor of Fluid Responsiveness in Patients Ventilated With Low Tidal Volume: A Systematic Review and Meta-Analysis
2020, Clinical Medicine Insights: Circulatory, Respiratory and Pulmonary Medicine