Responsiveness of stroke volume variation and central venous pressure during acute normovolemic and hypervolemic hemodilution

Fu Hai Ji, Wen Jing Li, Jiang Li, Ke Peng, Jian Ping Yang, Hong Liu

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Background Stroke volume variation (SVV) is a robust indicator of fluid responsiveness during volume change. We compared the sensibility of SVV by Vigileo/Flotrac to central venous pressure (CVP) when volume changes in patients undergoing intraoperative acute normovolemic hemodilution (ANH) and acute hypervolemic hemodilution (AHH). Methods Forty patients were randomly divided into an ANH group (n=20) and an AHH group (n=20). All patients received general anesthesia and were mechanically ventilated. Data were collected from 7 different time-points in the ANH group: baseline, after withdrawal of 5%, 10%, and 15% of the estimated blood volume (EBV) and after replacement with an equal volume of 6% hydroxyethyl starch 130/0.4 (HES) in 5% EBV increments to baseline. There were four time points in the AHH group: baseline, after 5%, 10%, and 15% expansion of the EBV with 6% HES. At each time-point, CVP, SVV and other hemodynamic parameters measurements were obtained. Results After removal of 10% and 15% EBV, SVV significantly increased from 10.9±3.0 to 14.1±3.4 and 10.9±3.0 to16.0±3.3 (P <0.01), and returned to a final value of 10.6±3.4 after volume replacement. The CVP value was unchanged after removal and replacement of 15% of the EBV. There were no significant changes in SVV after 5%, 10% whereas there was a significant reduction after 15% (8.2±1.7) expansion of the EBV compared with baseline (9.9±1.8) (P=0.033). However, there was a significant increase in CVP after10% (10.3±2.4), 15% (11.3±2.2) expansion of the EBV compared with baseline (8.2±2.7) (P <0.01). Conclusion SVV is a more sensitive parameter for volume than CVP during hypovolemia, on the contrary CVP is more sensitive than SVV during hypervolemia.

Original languageEnglish (US)
Pages (from-to)1838-1843
Number of pages6
JournalChinese Medical Journal
Volume126
Issue number10
DOIs
StatePublished - May 20 2013

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Hemodilution
Central Venous Pressure
Blood Volume
Stroke Volume
Hydroxyethyl Starch Derivatives
Hypovolemia
General Anesthesia
Hemodynamics

Keywords

  • Central venous pressure
  • Hemodilution
  • Stroke volume variation

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Responsiveness of stroke volume variation and central venous pressure during acute normovolemic and hypervolemic hemodilution. / Ji, Fu Hai; Li, Wen Jing; Li, Jiang; Peng, Ke; Yang, Jian Ping; Liu, Hong.

In: Chinese Medical Journal, Vol. 126, No. 10, 20.05.2013, p. 1838-1843.

Research output: Contribution to journalArticle

Ji, Fu Hai ; Li, Wen Jing ; Li, Jiang ; Peng, Ke ; Yang, Jian Ping ; Liu, Hong. / Responsiveness of stroke volume variation and central venous pressure during acute normovolemic and hypervolemic hemodilution. In: Chinese Medical Journal. 2013 ; Vol. 126, No. 10. pp. 1838-1843.
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abstract = "Background Stroke volume variation (SVV) is a robust indicator of fluid responsiveness during volume change. We compared the sensibility of SVV by Vigileo/Flotrac to central venous pressure (CVP) when volume changes in patients undergoing intraoperative acute normovolemic hemodilution (ANH) and acute hypervolemic hemodilution (AHH). Methods Forty patients were randomly divided into an ANH group (n=20) and an AHH group (n=20). All patients received general anesthesia and were mechanically ventilated. Data were collected from 7 different time-points in the ANH group: baseline, after withdrawal of 5{\%}, 10{\%}, and 15{\%} of the estimated blood volume (EBV) and after replacement with an equal volume of 6{\%} hydroxyethyl starch 130/0.4 (HES) in 5{\%} EBV increments to baseline. There were four time points in the AHH group: baseline, after 5{\%}, 10{\%}, and 15{\%} expansion of the EBV with 6{\%} HES. At each time-point, CVP, SVV and other hemodynamic parameters measurements were obtained. Results After removal of 10{\%} and 15{\%} EBV, SVV significantly increased from 10.9±3.0 to 14.1±3.4 and 10.9±3.0 to16.0±3.3 (P <0.01), and returned to a final value of 10.6±3.4 after volume replacement. The CVP value was unchanged after removal and replacement of 15{\%} of the EBV. There were no significant changes in SVV after 5{\%}, 10{\%} whereas there was a significant reduction after 15{\%} (8.2±1.7) expansion of the EBV compared with baseline (9.9±1.8) (P=0.033). However, there was a significant increase in CVP after10{\%} (10.3±2.4), 15{\%} (11.3±2.2) expansion of the EBV compared with baseline (8.2±2.7) (P <0.01). Conclusion SVV is a more sensitive parameter for volume than CVP during hypovolemia, on the contrary CVP is more sensitive than SVV during hypervolemia.",
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T1 - Responsiveness of stroke volume variation and central venous pressure during acute normovolemic and hypervolemic hemodilution

AU - Ji, Fu Hai

AU - Li, Wen Jing

AU - Li, Jiang

AU - Peng, Ke

AU - Yang, Jian Ping

AU - Liu, Hong

PY - 2013/5/20

Y1 - 2013/5/20

N2 - Background Stroke volume variation (SVV) is a robust indicator of fluid responsiveness during volume change. We compared the sensibility of SVV by Vigileo/Flotrac to central venous pressure (CVP) when volume changes in patients undergoing intraoperative acute normovolemic hemodilution (ANH) and acute hypervolemic hemodilution (AHH). Methods Forty patients were randomly divided into an ANH group (n=20) and an AHH group (n=20). All patients received general anesthesia and were mechanically ventilated. Data were collected from 7 different time-points in the ANH group: baseline, after withdrawal of 5%, 10%, and 15% of the estimated blood volume (EBV) and after replacement with an equal volume of 6% hydroxyethyl starch 130/0.4 (HES) in 5% EBV increments to baseline. There were four time points in the AHH group: baseline, after 5%, 10%, and 15% expansion of the EBV with 6% HES. At each time-point, CVP, SVV and other hemodynamic parameters measurements were obtained. Results After removal of 10% and 15% EBV, SVV significantly increased from 10.9±3.0 to 14.1±3.4 and 10.9±3.0 to16.0±3.3 (P <0.01), and returned to a final value of 10.6±3.4 after volume replacement. The CVP value was unchanged after removal and replacement of 15% of the EBV. There were no significant changes in SVV after 5%, 10% whereas there was a significant reduction after 15% (8.2±1.7) expansion of the EBV compared with baseline (9.9±1.8) (P=0.033). However, there was a significant increase in CVP after10% (10.3±2.4), 15% (11.3±2.2) expansion of the EBV compared with baseline (8.2±2.7) (P <0.01). Conclusion SVV is a more sensitive parameter for volume than CVP during hypovolemia, on the contrary CVP is more sensitive than SVV during hypervolemia.

AB - Background Stroke volume variation (SVV) is a robust indicator of fluid responsiveness during volume change. We compared the sensibility of SVV by Vigileo/Flotrac to central venous pressure (CVP) when volume changes in patients undergoing intraoperative acute normovolemic hemodilution (ANH) and acute hypervolemic hemodilution (AHH). Methods Forty patients were randomly divided into an ANH group (n=20) and an AHH group (n=20). All patients received general anesthesia and were mechanically ventilated. Data were collected from 7 different time-points in the ANH group: baseline, after withdrawal of 5%, 10%, and 15% of the estimated blood volume (EBV) and after replacement with an equal volume of 6% hydroxyethyl starch 130/0.4 (HES) in 5% EBV increments to baseline. There were four time points in the AHH group: baseline, after 5%, 10%, and 15% expansion of the EBV with 6% HES. At each time-point, CVP, SVV and other hemodynamic parameters measurements were obtained. Results After removal of 10% and 15% EBV, SVV significantly increased from 10.9±3.0 to 14.1±3.4 and 10.9±3.0 to16.0±3.3 (P <0.01), and returned to a final value of 10.6±3.4 after volume replacement. The CVP value was unchanged after removal and replacement of 15% of the EBV. There were no significant changes in SVV after 5%, 10% whereas there was a significant reduction after 15% (8.2±1.7) expansion of the EBV compared with baseline (9.9±1.8) (P=0.033). However, there was a significant increase in CVP after10% (10.3±2.4), 15% (11.3±2.2) expansion of the EBV compared with baseline (8.2±2.7) (P <0.01). Conclusion SVV is a more sensitive parameter for volume than CVP during hypovolemia, on the contrary CVP is more sensitive than SVV during hypervolemia.

KW - Central venous pressure

KW - Hemodilution

KW - Stroke volume variation

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