Published in:
Open Access
01-08-2021 | Stroke | Original Article
Assessing volume responsiveness using right ventricular dynamic indicators of preload
Authors:
Michael F. Graessler, Karin H. Wodack, Hans O. Pinnschmidt, Sarah Nishimoto, Christoph R. Behem, Daniel A. Reuter, Constantin J. C. Trepte
Published in:
Journal of Anesthesia
|
Issue 4/2021
Login to get access
Abstract
Purpose
Dynamic indicators of preload currently only do reflect preload requirements of the left ventricle. To date, no dynamic indicators of right ventricular preload have been established. The aim of this study was to calculate dynamic indicators of right ventricular preload and assess their ability to predict ventricular volume responsiveness.
Materials and methods
The study was designed as experimental trial in 20 anaesthetized pigs. Micro-tip catheters and ultrasonic flow probes were used as experimental reference to enable measurement of right ventricular stroke volume and pulse pressure. Hypovolemia was induced (withdrawal of blood 20 ml/kg) and thereafter three volume-loading steps were performed. ROC analysis was performed to assess the ability of dynamic right ventricular parameters to predict volume response.
Results
ROC analysis revealed an area under the curve (AUC) of 0.82 (CI 95% 0.73–0.89; p < 0.001) for right ventricular stroke volume variation (SVVRV), an AUC of 0.72 (CI 95% 0.53–0.85; p = 0.02) for pulmonary artery pulse pressure variation (PPVPA) and an AUC of 0.66 (CI 95% 0.51–0.79; p = 0.04) for pulmonary artery systolic pressure variation (SPVPA).
Conclusions
In our experimental animal setting, calculating dynamic indicators of right ventricular preload is possible and appears promising in predicting volume responsiveness.