Skip to main content
Key Specialties
Cardiology Diabetology Endocrinology Gastroenterology Geriatrics and Gerontology Gynecology and Obstetrics Hematology Infectious Disease Internal Medicine Nephrology Neurology Oncology Pediatrics Respiratory Medicine Rheumatology Surgery
Congress Coverage
2024 ACC Congress 2023 ESMO Congress 2023 EASD Congress 2023 ERS Congress 2023 ESC Congress 2023 EHA Congress 2023 ASCO Annual Meeting
Clinical Collections
Advances in Alzheimer’s

At a glance: The ONWARDS insulin icodec trials

A round-up of the ONWARDS phase 3 clinical trials evaluating the novel weekly insulin icodec in people with diabetes.
ADVANCED SEARCH
Log in
Top
BMC Anesthesiology
Published in: BMC Anesthesiology 1/2017

Open Access 01-12-2017 | Research article

The ability of left ventricular end-diastolic volume variations measured by TEE to monitor fluid responsiveness in high-risk surgical patients during craniotomy: a prospective cohort study

Authors: Haidan Lan, Xiaoshuang Zhou, Jing Xue, Bin Liu, Guo Chen

Published in: BMC Anesthesiology | Issue 1/2017

Login to get access

Abstract

Background

This study was aimed to evaluate the ability of left ventricular end-diastolic volume variations (LVEDVV) measured by transesophageal echocardiography (TEE) compared with stroke volume variation (SVV) obtained by the FloTrac/Vigileo monitor to predict fluid responsiveness, in patients undergoing craniotomy with goal direct therapy.

Methods

We used SVV obtained by the FloTrac/Vigileo monitor to manage intraoperative hypotension in adult patients undergoing craniotomy (ASA III – IV) after obtaining IRB approval and informed consent. The LVEDVV were measured by TEE through the changes of left ventricular short diameter of axle simultaneously. When cardiac index (CI) ≤ 2.5 and SVV ≥ 15%, comparisons were made between the two devices before and after volume expansion.

Results

We enrolled twenty-six patients referred for craniotomy in this study and 145 pairs of data were obtained. Mean Vigileo-SVV and TEE-LVEDVV were 17.8 ± 2.78% and 22.1 ± 7.25% before volume expansion respectively, and were 10.95 ± 2.8% and 13.58 ± 3.78% after volume expansion respectively (P < 0.001). The relationship between Vigileo-SVV and TEE-LVEDVV was significant (r2 = 0.55; p < 0.001). Agreement between Vigileo-SVV and TEE-LVEDVV was 3.3% ± 3.9% (mean bias ± SD, Bland-Altman).

Conclusions

For fluid responsiveness of patients during craniotomy in ASA III-IV, LVEDVV measured by left ventricular short diameter of axle using M type echocaidiographic measurement seems an acceptable monitoring indicator. This accessible method has promising clinical applications in situations where volume and cardiac function monitoring is of great importance during surgery.

Trial registration

Chinese Clinical Trial Registry, ChiCTR-TRC-13003583, August 20, 2013.
Literature
1.
2.
Bagshaw SM, Brophy PD, Cruz D, Ronco C. Fluid balance as a biomarker: impact of fluid overload on outcome in critically ill patients with acute kidney injury. Crit Care. 2008;12:169.CrossRefPubMedPubMedCentral
3.
Benes J, Giglio M, Brienza N, Michard F. The effects of goal-directed fluid therapy based on dynamic parameters on post-surgical outcome: a meta-analysis of randomized controlled trials. Crit Care. 2014;18:584.CrossRefPubMedPubMedCentral
4.
5.
JY X, Chen QH, Liu SQ, Pan C, XP X, Han JB, Xie JF, Huang YZ, Guo FM, Yang Y, Qiu HB. The effect of early goal-directed therapy on outcome in adult severe sepsis and septic shock patients: a meta-analysis of randomized clinical trials. Anesth Analg. 2016;123:371–81.
6.
Kapoor PM, Magoon R, Rawat R, Mehta Y. Perioperative utility of goal-directed therapy in high-risk cardiac patients undergoing coronary artery bypass grafting: "a clinical outcome and biomarker-based study". Ann Card Anaesth. 2016;19:638–82.CrossRefPubMedPubMedCentral
7.
Davies SJ, Minhas S, Wilson RJ, Yates D, Howell SJ. Comparison of stroke volume and fluid responsiveness measurements in commonly used technologies for goal-directed therapy. J Clin Anesth. 2013;25:466–74.CrossRefPubMed
8.
Lahner D, Kabon B, Marschalek C, Chiari A, Pestel G, Kaider A, Fleischmann E, Hetz H. Evaluation of stroke volume variation obtained by arterial pulse contour analysis to predict fluid responsiveness intraoperatively. Br J Anaesth. 2009;103:346–51.CrossRefPubMed
9.
Cannesson M, Musard H, Desebbe O, Boucau C, Simon R, Henaine R, Lehot JJ. The ability of stroke volume variations obtained with Vigileo/FloTrac system to monitor fluid responsiveness in mechanically ventilated patients. Anesth Analg. 2009;108:513–7.CrossRefPubMed
10.
Yang XB, Du B. Does pulse pressure variation predict fluid responsiveness in critically ill patients? A systematic review and meta-analysis. Crit Care. 2014;18
11.
Vergnaud E, Vidal C, Verchere J, Miatello J, Meyer P, Carli P, Orliaguet G. Stroke volume variation and indexed stroke volume measured using bioreactance predict fluid responsiveness in postoperative children. Br J Anaesth. 2015;114:103–9.CrossRefPubMed
12.
Lee JY, Kim JY, Choi CH, Kim HS, Lee KC, Kwak HJ. The ability of stroke volume variation measured by a noninvasive cardiac output monitor to predict fluid responsiveness in mechanically ventilated children. Pediatr Cardiol. 2014;35:289–94.CrossRefPubMed
13.
Mahmood F, Shernan SK. Perioperative transoesophageal echocardiography: current status and future directions. Heart. 2016;102:1159–67.CrossRefPubMed
14.
Luo J, Xue J, Liu J, Liu B, Liu L, Chen G. Goal-directed fluid restriction during brain surgery: a prospective randomized controlled trial. Ann Intensive Care. 2017;7:16.CrossRefPubMedPubMedCentral
15.
Funk DJ, Moretti EW, Gan TJ. Minimally invasive cardiac output monitoring in the perioperative setting. Anesth Analg. 2009;108:887–97.CrossRefPubMed
16.
Gula LJ, Massel D, Redfearn DP, Krahn AD, Yee R, Klein GJ, Skanes AC. Impact of routine transoesophageal echocardiography on safety, outcomes, and cost of pulmonary vein ablation: inferences drawn from a decision analysis model. Europace. 2010;12:1550–7.CrossRefPubMed
17.
Heiberg J, El-Ansary D, Royse CF, Royse AG, Alsaddique AA, Canty DJ. Transthoracic and transoesophageal echocardiography: a systematic review of feasibility and impact on diagnosis, management and outcome after cardiac surgery. Anaesthesia. 2016;71:1210–21.CrossRefPubMed
18.
Tsai YF, Liu FC, FloTrac YHP. Vigileo system monitoring in acute-care surgery: current and future trends. Expert Rev Med Devices. 2013;10:717–28.CrossRefPubMed
19.
Senn A, Button D, Zollinger A, Hofer CK. Assessment of cardiac output changes using a modified FloTrac/Vigileo algorithm in cardiac surgery patients. Crit Care. 2009;13:R32.CrossRefPubMedPubMedCentral
20.
Biancofiore G, Critchley LA, Lee A, Yang XX, Bindi LM, Esposito M, Bisa M, Meacci L, Mozzo R, Filipponi F. Evaluation of a new software version of the FloTrac/Vigileo (version 3.02) and a comparison with previous data in cirrhotic patients undergoing liver transplant surgery. Anesth Analg. 2011;113:515–22.PubMed
21.
Scheeren TW, Wiesenack C, Gerlach H, Marx G. Goal-directed intraoperative fluid therapy guided by stroke volume and its variation in high-risk surgical patients: a prospective randomized multicentre study. J Clin Monit Comput. 2013;27:225–33.CrossRefPubMed
Metadata
Title
The ability of left ventricular end-diastolic volume variations measured by TEE to monitor fluid responsiveness in high-risk surgical patients during craniotomy: a prospective cohort study
Authors
Haidan Lan
Xiaoshuang Zhou
Jing Xue
Bin Liu
Guo Chen
Publication date
01-12-2017
Publisher
BioMed Central
Published in
BMC Anesthesiology / Issue 1/2017
Electronic ISSN: 1471-2253
DOI
https://doi.org/10.1186/s12871-017-0456-6

Other articles of this Issue 1/2017

BMC Anesthesiology 1/2017 Go to the issue

Research article

Dexmedetomidine in combination with sufentanil for postoperative analgesia after partial laryngectomy

Research article

The value of arterial pressure waveform cardiac output measurements in the radial and femoral artery in major cardiac surgery patients

Research article

Effect of desflurane-remifentanil vs. Propofol-remifentanil anesthesia on arterial oxygenation during one-lung ventilation for thoracoscopic surgery: a prospective randomized trial

Research article

Prediction of the optimal depth for superior vena cava cannulae with cardiac computed tomography during minimally invasive cardiac surgery: a prospective observational cohort study

Research article

The current level of shared decision-making in anesthesiology: an exploratory study

Research article

Lipid emulsion mitigates impaired pulmonary function induced by limb ischemia/reperfusion in rats through attenuation of local cellular injury and the subsequent systemic inflammatory