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Abstract

Background

Currently, physicians employ pulse pressure variation (PPV) as a gold standard for predicting fluid responsiveness. However, employing ultrasonography in intensive care units is increasing, including using the ultrasonography for assessment of fluid responsiveness. Data comparing the performance of both methods are still lacking. This is the reason for the present study.

Materials and methods

We conducted a prospective observational study in patients with sepsis requiring fluid challenge. The PPV, inferior vena cava diameter variation (IVDV), stroke volume variation (SVV), and the other hemodynamic variables were recorded before and after fluid challenges. Fluid responders were identified when cardiac output increased more than 15% after fluid loading.

Results

A total of 29 patients with sepsis were enrolled in this study. Sixteen (55.2%) were fluid responders. Threshold values to predict fluid responsiveness were 13.8% of PPV (sensitivity 100% and specificity 84.6%), 10.2% of IVDV (sensitivity 75% and specificity 76.9%) and 10.7% of SVV (sensitivity 81.3% and specificity 76.9%). The area under the curves of receiver operating characteristic showed that PPV (0.909, 95% confidence interval [CI], 0.784-1.00) and SVV (0.812, 95% CI, 0.644-0.981) had greater performance than IVDV (0.688, 95% CI, 0.480-0.895) regarding fluid responsiveness assessment.

Conclusions

The present study demonstrated better performance of the PPV than the IVDV. A threshold value more than 10% may be used for identifying fluid responders.

Details

Title
Inferior vena cava diameter variation compared with pulse pressure variation as predictors of fluid responsiveness in patients with sepsis
Author
Theerawit, Pongdhep; Morasert, Thotsaporn; Sutherasan, Yuda
Pages
246-251
Section
Sepsis/Infection
Publication year
2016
Publication date
Dec 01, 2016
Publisher
Elsevier Limited
ISSN
08839441
e-ISSN
15578615
Source type
Scholarly Journal
Language of publication
English
ProQuest document ID
1837588536
Copyright
Copyright Elsevier Limited Dec 01, 2016