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Published in: Journal of Anesthesia 4/2021

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

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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.
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Metadata
Title
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
Publication date
01-08-2021
Publisher
Springer Singapore
Keyword
Stroke
Published in
Journal of Anesthesia / Issue 4/2021
Print ISSN: 0913-8668
Electronic ISSN: 1438-8359
DOI
https://doi.org/10.1007/s00540-021-02937-5

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