With a CVP catheter, its signal may be interfaced with the Vigileo, allowing for the calculation of SVR and SVRI. All invasive cannulations were performed under local analgesia with 1% lidocaine.Ĭontinuous CO was acquired with the FloTrac/Vigileo system by analyzing the arterial pulse wave following semi-invasive arterial catheterization without pulmonary artery catheterization or calibration with another method, which can monitor CO, CI, SV, SVI and SVV. After anaesthesia induction, a 7.5-F central venous catheter was introduced via right internal jugular vein for measuring the central venous pressure (CVP). Before anaesthesia induction, the left radial artery was cannulated with a 20-G cannula which was connected to a FloTrac sensor and a Vigileo monitor (software version 3.06) for continuous monitoring of CO, cardiac index (CI), stroke volume (SV), stroke volume index (SVI), SVV, systemic vascular resistance (SVR) and systemic vascular resistance index (SVRI). Routine haemodynamic monitoring was performed to measure the heart rate (HR), pulse oximetry, electrocardiograph, and arterial blood pressure. The present study was performed to investigate the value of SVV in predicting fluid responsiveness in patients receiving gastrointestinal surgery in the presence of ventilation with intermittent positive-pressure ventilation (IPPV) mode, and conventional/low tidal volume. The accuracy and reliability of CO has been evaluated 16, 17, while the accuracy and clinical applicability of SVV measured with this system have not been fully evaluated 18 - 25. Recently, arterial pulse waveform analysis has been proposed for monitoring of cardiac output (CO) and SVV (FloTrac/Vigileo Edwards Lifesciences, Irvine, CA, USA) 12 - 15. As an alternative to these static variables, assessment of stroke volume variation (SVV) has been used as a indicator for haemodynamic monitoring to predict fluid responsiveness in patients receiving mechanical ventilation 4 - 11. Frequently used standard preload indexes, such as central venous pressure (CVP), pulmonary artery occlusion pressure (PAOP), intrathoracic blood volume index (ITBI) and left ventricular end-diastolic area index (LVEDAI) often fail to provide reliable information and usually predict fluid responsiveness with conflicting results 1 - 4. Precise assessment of volume state is a prerequisite for adequate volume replacement which may achieve optimal organ perfusion and oxygen supply. Conclusion: SVV measured by FloTrac/Vigileo system can predict fluid responsiveness in patients undergoing ventilation with low tidal volumes during gastrointestinal surgery. The largest area under the ROC curve (AUC) was found for SVV (Group C, 0.852 Group L, 0.814), and the AUC for other preloading indices in two groups ranged from 0.324 to 0.460. SVI was significantly correlated to the SVV before fluid loading (Group C: r = 0.909 Group L: r = 0.758) but not the HR, MAP, CVP and SVR before fluid loading. SVI was significantly correlated to the SVV, CVP but not the HR, MAP and SVR. Results: After fluid loading, the MAP, CVP, SVI and CI increased significantly, whereas the SVV and SVR decreased markedly in both groups. Besides standard haemodynamic monitoring, SVV, cardiac output, cardiac index (CI), stroke volume (SV), stroke volume index (SVI), systemic vascular resistance (SVR) and systemic vascular resistance index (SVRI) were determined with the FloTrac/Vigileo system before and after fluid loading. After anesthesia induction, 6% hydroxyethyl starch130/0.4 solution (7 ml/kg) was intravenously transfused. Methods: Fifty patients undergoing elective gastrointestinal surgery were randomly divided into two groups: Group C and Group L. However, the predictive role of SVV measured by FloTrac/Vigileo system in prediction of fluid responsiveness was unproven in patients undergoing ventilation with low tidal volume. Background: Stroke volume variation (SVV) has been shown to be a reliable predictor of fluid responsiveness.
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