The clinical value of stroke volume variation and pleth variability index in predicting fluid responsiveness during increased intra-abdominal pressure

Abstract

Objective To evaluate the abilities and thresholds of stroke volume variation (SVV) and pleth variability index (PVI) in predicting fluid responsiveness during increased intra-abdominal pressure.Methods 28 patients undergoing laparoscopy-assisted radical gastrectomy were selected.PV1 was continuously displayed by the Masimo.Radical 7.All patients were also monitored with Vigileo/FloTrac system.Haemodynamic data such as MAP,HR,SVI,SVV,PI,PVI and C VP were recorded before and after volume expansion(HES 6％,7ml/kg).Fluid responsiveness was defined as an increase in SVI≥ 15％ (△ SVI ≥ 15).Results The SVV threshold of 9.5％ before volume expansion was able to diserimihate the responders from the non-responders with a sensitivity of 100％,and a specificity of 63.6％.The threshold for PVI was 14.0％,the sensitivity of 100％ and specificity of 81.8％ were obtained.There was no significant difference between the area under the receiver operating characteristics (ROC) curves of SVV and PVI(0.981,0.939,respectively),and there was significant correlation between the baseline SVV and the baseline PVI(r =0.740,P ＜ 0.01).Conclusion SVV and PVI can predict fluid responsiveness accurately during increased intra-abdominal pressure,the baseline SVV is correlated well with baseline PVI,and the ability of SVV and PVI in predicting fluid responsiveness is similar. Key words: Pneumoperitoneum, artificial ; Stroke volume ; Echocardiography, stress; Pulsatile flow