Mini-fluid challenge predicts fluid responsiveness during spontaneous breathing under spinal anaesthesia: An observational study.
Eur J Anaesthesiol
; 32(9): 645-9, 2015 Sep.
Article
in En
| MEDLINE
| ID: mdl-25329455
ABSTRACT
BACKGROUND:
The ability to predict fluid responsiveness in spontaneously breathing patients under spinal anaesthesia is desirable.OBJECTIVE:
The objective of this study was to test whether variations in stroke volume (SV) in response to a fixed mini-fluid challenge (ΔSV100) measured by thoracic impedance cardiography (ICG) can predict fluid responsiveness in spontaneously breathing patients under spinal anaesthesia.DESIGN:
A prospective observational study.SETTING:
Anaesthesiology department in a university hospital.PARTICIPANTS:
Seventy-three patients monitored by ICG during surgery under spinal anaesthesia.INTERVENTIONS:
Patients received a 100 ml fluid challenge followed by volume expansion with 500 ml of crystalloid. MAIN OUTCOMESMEASURES:
Haemodynamic variables and bioimpedance indices [blood pressure, SV, cardiac output (CO)] were measured before and after fluid challenge and before and after volume expansion. Responders were defined as those with >15% increase in SV after volume expansion.RESULTS:
SV increased by at least 15% in 27 (37%) of the 73 patients. ΔSV100 predicted fluid responsiveness with an area under the receiver operating characteristic (AUC) curve of 0.93 [95% confidence interval (95% CI) 0.8 to 0.97, P < 0.001]. The cut-off was 7% and a grey zone ranging between 3 and 8% was observed in up to 14% of patients. SV baseline was a poor predictor of fluid responsiveness [AUC of 0.69 (95% CI 0.57 to 0.79, P = 0.002)].CONCLUSION:
ΔSV100 greater than 7% accurately predicted fluid responsiveness during surgery with a grey zone ranging between 3 and 8%.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Respiration
/
Monitoring, Intraoperative
/
Fluid Therapy
/
Isotonic Solutions
/
Anesthesia, Spinal
Type of study:
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Aged
/
Aged80
/
Female
/
Humans
/
Male
/
Middle aged
Language:
En
Journal:
Eur J Anaesthesiol
Journal subject:
ANESTESIOLOGIA
Year:
2015
Document type:
Article
Affiliation country:
Publication country:
ENGLAND
/
ESCOCIA
/
GB
/
GREAT BRITAIN
/
INGLATERRA
/
REINO UNIDO
/
SCOTLAND
/
UK
/
UNITED KINGDOM