Comparison of noninvasive dynamic indices of fluid responsiveness among different ventilation modes in dogs recovering from experimental cardiac surgery

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Abstract

Background: Fluid resuscitation is a cornerstone of minimizing morbidity and mortality in critically ill patients, but the techniques for predicting fluid responsiveness is still a matter of debate. In this study, we aimed to evaluate the utility of noninvasive stroke volume variation (SVV), pulse pressure variation (PPV), and systolic pressure variation (SPV) as a dynamic predictor for assessing fluid responsiveness during different ventilation modes in anaesthetized, intubated dogs recovering from cardiac surgery. Material/Methods: Thirty-six adult Beagle dogs undergoing experimental surgery for isolated right ventricular failure were monitored for SVV, PPV, and SPV simultaneously using electrical velocimetry device. The relationships between each indicator and SVI before and after volume loading were compared in 3 ventilatory modes: assist control (A/C), synchronized intermittent mandatory ventilation (SIMV), and continuous positive airway pressure (CPAP). Responders were defined as those whose stroke volume index increased by ≥10%. Results: In all of the indices, the baseline values were greater in responders than in nonresponders (P<0.01) under A/C and SIMV. Receiver operating curve analysis confirmed the best predictive value during A/C [area under the curve (AUC): SVV, 0.90; PPV, 0.88; SPV, 0.85; P<0.05] followed by SIMV (AUC: SVV, 0.86; PPV, 0.83; CPAP, 0.80; P<0.05), with their sensitivities and specificities of ≥7 5%. By contrast, no statistically significance detected in any parameter during CPAP (AUC: SVV, 0.71; PPV, 0.66; CPAP, 0.65; P>0.05). Conclusions: SVV, PPV, and SVV are all useful to predict cardiac response to fluid loading in dogs during A/C and SIMV, while their reliabilities during CPAP are poor.

Original languageEnglish
Pages (from-to)7736-7741
Number of pages6
JournalMedical Science Monitor
Volume24
DOIs
Publication statusPublished - 2018 Oct 29

Keywords

  • Artificial
  • Blood pressure
  • Dogs
  • Fluid therapy
  • Monitoring, intraoperative
  • Respiration
  • Stroke volume

ASJC Scopus subject areas

  • Medicine(all)

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