Influence Of Intra-abdominal Hypertension And Position On The Accuracy And Thresholds Of Stroke Volume Variation And Pulse Pressure Variation In Predicting Fluid Responsiveness

Objective To evaluate the accuracy and threshold values of stroke volumevariation(SVV) and pulse pressure variation(PPV) in predicting fluid responsivenesswith intra-abdominal hypertension (IAH).Methods Twenty mechanically-ventilatedpatients undergoing Laparoscopy-assisted gastrointestinal surgery were studied．Whenthe needed position was prepared,IAP was increased to12mmHg and maintained at thislevel,then mean arterial pressure(MAP)，heart rate(HR)，central venous pressure(CVP),cardiac output（CO）,cardiac index(CI)，stroke volume(SV), stroke volumeindex(SVI),SVV and PPV were recorded before and after fluid thempy(FT)．Thechanging rate of SVI were calculated．The criterion for effective volume expansion wasΔSVI≥10％．Results The thresholds of SVV and PPV were10.5%and11.5%respectively in predicting fluid responsiveness with IAH. Conclusion Fluidresponsiveness in patients was predicted by a SVV threshold of>10.5%and an PPVthreshold of>11.5%. SVV and PPV were demonstrated to be sensitive and specificpredictors of fluid responsiveness in patients with IAH in mechanicallyventilatedpatients under general anaesthesia. Objective To evaluate the accuracy and thresholds of stroke volume variation(SVV)and pulse pressure variation(PPV) in predicting fluid responsiveness withintra-abdominal hypertension(IAH) in a trendelenburg position. Methods Twentymechanically-ventilated patients undergoing Laparoscopy-assisted gastrointestinalsurgery were studied．When the needed position was prepared,IAP was increased to12mmHg and maintained at this level,then mean arterial pressure(MAP)，heart rate(HR)，central venous pressure (CVP),cardiac output （CO）,cardiac index(CI)， strokevolume(SV), stroke volume index(SVI),PPV and SVV were recorded before and afterfluid thempy(FT)．The changing rate of SVI were calculated．The criterion for effectivevolume expansion wasΔSVI≥10％．Results The thresholds of SVV and PPV were7.0%and7.5%respectively in predicting fluid responsiveness with IAH in a trendelenburgposition. Conclusion Fluid responsiveness in patients in a Trendelenburg position waspredicted by a SVV threshold of>7.0%and an PPV threshold of>7.5%. SVV andPPV were demonstrated to be sensitive and specific predictors of fluid responsiveness inpatients with IAH in the Trendelenburg position in mechanically ventilated patientsunder general anaesthesia.