Comparative Study Of Volume Output Variability And Inferior Vena Cava Dilation Index In Predicting Volume Response After Pneumonectomy

ObjectiveWe evaluated the characteristics of hemodynamics and volume responsiveness to compare the accuracy of stroke volume variability(SVV)and inferior vena cava distensibility index(? DIVC)on blood volume status after total pneumonectomy.Methods we collected 18 patients who underwent hemodynamic monitoring after surgery with mechanical ventilation from August 2014 to April 2017 in ICUwith the research method of prospective control survey.Pulse indicator continuous cardiac output monitor(PiCCO)was used for monitoring SVV for all the patients and bedside ultrasound was performed to identify ?DIVC at the same time.Both the hemodynamics parameters of the baseline and those of the rehydration test(7ml/kg of hydroxyethyl starch,30min)were recorded.Reaction group(Group R)and no response group(Group NR)were marked according to ? Cl greater than 15%.ROC curve of the SVV and ? DIVC were analyzed respectively.HR,MAP,CVP,CI were also recorded during the survey.Results18 patients were included in the study after total pneumonectomy,10 of which had volume reactivity and 8 had no volume reactivity.There was no statistically significant difference in SVI,HR,Cl,MAP and CVP between the two groups(P>0.05).Prediction of the CVP,SVV and ? DIVC in capacity reactive AUC were 0.604,0.893 and 0.863 after pneumonectomy patients with mechanical ventilation.Prediction of the CVP in capacity reactive was no statistical Significance.Prediction of the SVV,? DIVC were statistically significant(P<0.05).SVV predicted the sensitivity of volume reactivitywas 75 percentand the specificity was 100%.? DIVC sensitivity was 81.8%and specificity 85.7%.Conclusion SVV and ? DIVC are reliable and important parameters to evaluate the capacity reactivity after pneumonectomy.