Abstract
Background
Haemodynamic monitoring of patients after cardiac surgery using echocardiographic evaluation of fluid responsiveness is both challenging and increasingly popular. We evaluated fluid responsiveness in the first hours after surgery by determining the variability of the velocity–time integral of the left ventricular outflow tract (VTI-LVOT).
Methods
We conducted a cross-sectional study of 50 consecutive adult patients who underwent cardiac surgery and in whom it was possible to obtain VTI-LVOT measurements. We then determined the variability and correlations with our pulse pressure variation (PPV) measurements to predict fluid responsiveness.
Results
A strong positive correlation was seen between the VTI-LVOT variability index absolute values and PPV for predicting fluid responsiveness in the first hours after cardiac surgery. We also found that the VTI-LVOT variability index has high specificity and a high positive likelihood ratio compared with the gold standard using a cut-off point of ≥ 12%.
Conclusions
The VTI-LVOT variability index is a valuable tool for determining fluid responsiveness during the first 6 postoperative hours in patients undergoing cardiac surgery.
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Details
1 Instituto Nacional de Cardiología Ignacio Chávez, Cardiovascular Critical Care Unit, Mexico City, Mexico (GRID:grid.419172.8) (ISNI:0000 0001 2292 8289)
2 Instituto Nacional de Cardiología Ignacio Chávez, Adult Congenital Heart Disease Unit, Mexico City, Mexico (GRID:grid.419172.8) (ISNI:0000 0001 2292 8289)
3 Instituto Nacional de Cardiología Ignacio Chávez, Coronary Care Unit, Mexico City, Mexico (GRID:grid.419172.8) (ISNI:0000 0001 2292 8289)