PREDICT FLUID RESPONSIVENESS AFTER OFF-PUMP CORONARY ARTERY BYPASS GRAFTING
https://doi.org/10.21292/2078-5658-2018-15-5-5-13
Abstract
Thirty-two adult patients after off-pump coronary artery bypass grafting were enrolled into a prospective observational study. All patients received positive end expiratory pressure test (PEEP-test), mini-fluid challenge test (mFCT) and standard fluid challenge test (sFCT). Pulse pressure variation using two monitoring systems (PPVPiCCO, PPVNK), Stroke volume variation (SVV), heart-lung index (HLI) and plethysmogram variability index (PVI) were assessed before and after sFCT. The patients with an increase in cardiac index by ≥15% after fluid challenge were defined as fluid responders. According to receiver operating characteristic analysis, changes in mean arterial pressure induced by PEEP-test identified fluid responsiveness with AUC 0.73 (p= 0.03). The reduction in PPVPiCCO and SVV during mFCT predicted positive response to the fluid load with AUC 0.77 and 0.75, respectively (p< 0.05). Response to sFLT can be predicted by the assessment of PPVPiCCO (AUC 0.84), PPVNK (AUC 0.71), SVV (AUC 0.77) and HLI (AUC 0.77) (p< 0.05).
About the Authors
E. V. Fot
Northern State Medical University; E. E. Volosevich First Municipal Clinical Hospital.
Russian Federation
Russian Federation
Evgeniya V. Fot - Candidate of Medical Sciences, Associate Professor of Anesthesiology and Intensive Care Department.
51, Troitsky Ave., Arkhangelsk, 163000.
N. N. Isotova
Northern State Medical University.
Russian Federation
Russian Federation
Natalya N. Isotova Resident of Anesthesiology and Intensive Care Department.
51, Troitsky Ave., Arkhangelsk, 163000.
A. A. Smetkin
Northern State Medical University.
Russian Federation
Russian Federation
Aleksey A. Smetkin - Candidate of Medical Sciences, Associate Professor of Anesthesiology and Intensive Care Department.
51, Troitsky Ave., Arkhangelsk, 163000.
M. Yu. Kirov
Northern State Medical University.
Mikhail Yu. Kirov - Doctor of Medical Sciences, Professor,
Head of Anesthesiology and Intensive Care Department.
51, Troitsky Ave., Arkhangelsk, 163000.
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Review
For citations:
Fot E.V., Isotova N.N., Smetkin A.A., Kirov M.Yu. PREDICT FLUID RESPONSIVENESS AFTER OFF-PUMP CORONARY ARTERY BYPASS GRAFTING. Messenger of ANESTHESIOLOGY AND RESUSCITATION. 2018;15(5):5-13. (In Russ.) https://doi.org/10.21292/2078-5658-2018-15-5-5-13
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