Comparing Fluid Responsiveness Prediction with Two Monitoring Systems
Author Information
Author(s): Christoph K. Hofer, Alban Senn, Luc Weibel, Andreas Zollinger
Primary Institution: Institute of Anaesthesiology and Intensive Care Medicine, Triemli City Hospital, Zurich, Switzerland
Hypothesis
The study aims to compare the prediction of fluid responsiveness using stroke volume variation (SVV) from two different systems: FloTrac™/Vigileo™ and PiCCOplus™.
Conclusion
Both systems exhibited similar performances in predicting fluid responsiveness, but the FloTrac™ system had a lower threshold value.
Supporting Evidence
- The study found that body positioning significantly increased stroke volume.
- SVV measured by both systems decreased significantly after the position change.
- The optimal threshold for SVVFloTrac was 9.6% with a sensitivity of 91% and specificity of 83%.
- The optimal threshold for SVVPiCCO was 12.1% with a sensitivity of 87% and specificity of 76%.
- There was no significant difference in the areas under the curve for both systems.
Takeaway
Doctors used two different machines to see how well they could tell if patients needed more fluids, and both did a good job, but one machine said patients needed fluids at a lower level.
Methodology
Patients undergoing elective cardiac surgery were monitored using FloTrac™ and PiCCOplus™ systems to assess stroke volume variation before and after a change in body position.
Potential Biases
Potential bias due to the specific patient population and controlled conditions that may not apply to all critically ill patients.
Limitations
The study induced fluid shifts by changing body position rather than actual fluid administration, which may not reflect true fluid responsiveness.
Participant Demographics
40 patients, average age 66.5 years, ASA risk classification III, female/male ratio 1/4.
Statistical Information
P-Value
p<0.05
Confidence Interval
95% CI for AUCs
Statistical Significance
p<0.05
Digital Object Identifier (DOI)
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