Skip to main content

Advertisement

SpringerLink
Log in

Utility of stroke volume variation measured using non-invasive bioreactance as a predictor of fluid responsiveness in the prone position

  • Original Research
  • Published:
Journal of Clinical Monitoring and Computing Aims and scope Submit manuscript

Abstract

The aim of this prospective study was to evaluate the usefulness of stroke volume variation (SVV) derived from NICOM® to predict fluid responsiveness in the prone position. Forty adult patients undergoing spinal surgery in the prone position were included in this study. We measured SVV from NICOM® (SVVNICOM) and FloTrac™/Vigileo™ systems (SVVVigileo), and pulse pressure variation (PPV) using automatic (PPVauto) and manual (PPVmanual) calculations at four time points including supine and prone positions, and before and after fluid loading of 6 ml kg−1 colloid solution. Fluid responsiveness was defined as an increase in the cardiac index from Vigileo™ of ≥12 %. There were 19 responders and 21 non-responders. Prone positioning induced a significant decrease in SVVNICOM, SVVVigileo, PPVauto, and PPVmanual. However, all of these parameters successfully predicted fluid responsiveness in the prone position with area under the receiver-operator characteristic curves for SVVNICOM, SVVVigileo, PPVauto, and PPVmanual of 0.78 [95 % confidence interval (CI) 0.62–0.90, P = 0.0001], 0.79 (95 % CI 0.63–0.90, P = 0.0001), 0.76 (95 % CI 0.6–0.88, P = 0.0006), and 0.84 (95 % CI 0.69–0.94, P < 0.0001), respectively. The optimal cut-off values were 12 % for SVVNICOM, SVVVigileo, and PPVauto, and 10 % for PPVmanual. SVV from NICOM® successfully predicts fluid responsiveness during surgery in the prone position. This totally non-invasive technique for assessing individual functional intravenous volume status would be useful in a wide range of surgeries performed in the prone position.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3

Similar content being viewed by others

References

  1. Benes J, Chytra I, Altmann P, Hluchy M, Kasal E, Svitak R, Pradl R, Stepan M. Intraoperative fluid optimization using stroke volume variation in high risk surgical patients: results of prospective randomized study. Crit Care. 2010;14:R118. doi:10.1186/cc9070.

    Article  PubMed  PubMed Central  Google Scholar 

  2. Perel A, Habicher M, Sander M. Bench-to-bedside review: functional hemodynamics during surgery—should it be used for all high-risk cases? Crit Care. 2013;17:203. doi:10.1186/cc11448.

    Article  PubMed  PubMed Central  Google Scholar 

  3. Navarro LH, Bloomstone JA, Auler JO Jr, Cannesson M, Rocca GD, Gan TJ, Kinsky M, Magder S, Miller TE, Mythen M, Perel A, Reuter DA, Pinsky MR, Kramer GC. Perioperative fluid therapy: a statement from the international Fluid Optimization Group. Perioper Med (Lond). 2015;4:3. doi:10.1186/s13741-015-0014-z.

    Article  Google Scholar 

  4. Sudheer PS, Logan SW, Ateleanu B, Hall JE. Haemodynamic effects of the prone position: a comparison of propofol total intravenous and inhalation anaesthesia. Anaesthesia. 2006;61:138–41. doi:10.1111/j.1365-2044.2005.04464.x.

    Article  CAS  PubMed  Google Scholar 

  5. Edgcombe H, Carter K, Yarrow S. Anaesthesia in the prone position. Br J Anaesth. 2008;100:165–83. doi:10.1093/bja/aem380.

    Article  CAS  PubMed  Google Scholar 

  6. Biais M, Bernard O, Ha JC, Degryse C, Sztark F. Abilities of pulse pressure variations and stroke volume variations to predict fluid responsiveness in prone position during scoliosis surgery. Br J Anaesth. 2010;104:407–13. doi:10.1093/bja/aeq031.

    Article  CAS  PubMed  Google Scholar 

  7. Yang SY, Shim JK, Song Y, Seo SJ, Kwak YL. Validation of pulse pressure variation and corrected flow time as predictors of fluid responsiveness in patients in the prone position. Br J Anaesth. 2013;110:713–20. doi:10.1093/bja/aes475.

    Article  PubMed  Google Scholar 

  8. Marque S, Cariou A, Chiche JD, Squara P. Comparison between Flotrac–Vigileo and bioreactance, a totally noninvasive method for cardiac output monitoring. Crit Care. 2009;13:R73. doi:10.1186/Cc7884.

    Article  PubMed  PubMed Central  Google Scholar 

  9. Squara P, Rotcajg D, Denjean D, Estagnasie P, Brusset A. Comparison of monitoring performance of Bioreactance vs. pulse contour during lung recruitment maneuvers. Crit Care. 2009;13:R125. doi:10.1186/cc7981.

    Article  PubMed  PubMed Central  Google Scholar 

  10. Vergnaud E, Vidal C, Verchere J, Miatello J, Meyer P, Carli P, Orliaguet G. Stroke volume variation and indexed stroke volume measured using bioreactance predict fluid responsiveness in postoperative children. Br J Anaesth. 2015;114:103–9. doi:10.1093/bja/aeu361.

    Article  CAS  PubMed  Google Scholar 

  11. Benomar B, Ouattara A, Estagnasie P, Brusset A, Squara P. Fluid responsiveness predicted by noninvasive bioreactance-based passive leg raise test. Intensive Care Med. 2010;36:1875–81. doi:10.1007/s00134-010-1990-6.

    Article  PubMed  Google Scholar 

  12. Marik PE, Levitov A, Young A, Andrews L. The use of bioreactance and carotid Doppler to determine volume responsiveness and blood flow redistribution following passive leg raising in hemodynamically unstable patients. Chest. 2013;143:364–70. doi:10.1378/chest.12-1274.

    Article  PubMed  Google Scholar 

  13. Pai MP, Paloucek FP. The origin of the “ideal” body weight equations. Ann Pharmacother. 2000;34:1066–9.

    Article  CAS  PubMed  Google Scholar 

  14. Aboy M, McNames J, Thong T, Phillips CR, Ellenby MS, Goldstein B. A novel algorithm to estimate the pulse pressure variation index deltaPP. IEEE Trans Biomed Eng. 2004;51:2198–203. doi:10.1109/TBME.2004.834295.

    Article  PubMed  Google Scholar 

  15. Cannesson M, Slieker J, Desebbe O, Bauer C, Chiari P, Henaine R, Lehot JJ. The ability of a novel algorithm for automatic estimation of the respiratory variations in arterial pulse pressure to monitor fluid responsiveness in the operating room. Anesth Analg. 2008;106:1195–200. doi:10.1213/01.ane.0000297291.01615.5c.

    Article  PubMed  Google Scholar 

  16. Raval NY, Squara P, Cleman M, Yalamanchili K, Winklmaier M, Burkhoff D. Multicenter evaluation of noninvasive cardiac output measurement by bioreactance technique. J Clin Monit Comput. 2008;22:113–9. doi:10.1007/s10877-008-9112-5.

    Article  PubMed  Google Scholar 

  17. Hajian-Tilaki K. Receiver operating characteristic (ROC) curve analysis for medical diagnostic test evaluation. Casp J Intern Med. 2013;4:627–35.

    Google Scholar 

  18. Frezza EE, Mezghebe H. Indications and complications of arterial catheter use in surgical or medical intensive care units: analysis of 4932 patients. Am Surg. 1998;64:127–31.

    CAS  PubMed  Google Scholar 

  19. Mermel LA. Prevention of intravascular catheter-related infections. Ann Intern Med. 2000;132:391–402.

    Article  CAS  PubMed  Google Scholar 

  20. Marque S, Cariou A, Chiche JD, Squara P. Comparison between Flotrac–Vigileo and bioreactance, a totally noninvasive method for cardiac output monitoring. Crit Care. 2009;13:R73. doi:10.1186/cc7884.

    Article  PubMed  PubMed Central  Google Scholar 

  21. Khan FZ, Virdee MS, Pugh PJ, Read PA, Fynn SP, Dutka DP. Non-invasive cardiac output measurements based on bioreactance for optimization of atrio- and interventricular delays. Europace. 2009;11:1666–74. doi:10.1093/europace/eup358.

    Article  PubMed  Google Scholar 

  22. Lee JY, Kim JY, Choi CH, Kim HS, Lee KC, Kwak HJ. The ability of stroke volume variation measured by a noninvasive cardiac output monitor to predict fluid responsiveness in mechanically ventilated children. Pediatr Cardiol. 2014;35:289–94. doi:10.1007/s00246-013-0772-7.

    Article  PubMed  Google Scholar 

  23. Grocott MP, Mythen MG, Gan TJ. Perioperative fluid management and clinical outcomes in adults. Anesth Analg. 2005;100:1093–106. doi:10.1213/01.ANE.0000148691.33690.AC.

    Article  PubMed  Google Scholar 

  24. Hojlund J, Sandmand M, Sonne M, Mantoni T, Jorgensen HL, Belhage B, van Lieshout JJ, Pott FC. Effect of head rotation on cerebral blood velocity in the prone position. Anesthesiol Res Pract. 2012;2012:647258. doi:10.1155/2012/647258.

    PubMed  PubMed Central  Google Scholar 

  25. Cannesson M, Le Manach Y, Hofer CK, Goarin JP, Lehot JJ, Vallet B, Tavernier B. Assessing the diagnostic accuracy of pulse pressure variations for the prediction of fluid responsiveness: a “gray zone” approach. Anesthesiology. 2011;115:231–41. doi:10.1097/ALN.0b013e318225b80a.

    Article  PubMed  Google Scholar 

  26. Michard F, Chemla D, Teboul JL. Applicability of pulse pressure variation: how many shades of grey? Crit Care. 2015;19:144. doi:10.1186/s13054-015-0869-x.

    Article  PubMed  PubMed Central  Google Scholar 

  27. Monnet X, Dres M, Ferre A, Le Teuff G, Jozwiak M, Bleibtreu A, Le Deley MC, Chemla D, Richard C, Teboul JL. Prediction of fluid responsiveness by a continuous non-invasive assessment of arterial pressure in critically ill patients: comparison with four other dynamic indices. Br J Anaesth. 2012;109:330–8. doi:10.1093/bja/aes182.

    Article  CAS  PubMed  Google Scholar 

  28. Biais M, Stecken L, Ottolenghi L, Roullet S, Quinart A, Masson F, Sztark F. The ability of pulse pressure variations obtained with CNAP device to predict fluid responsiveness in the operating room. Anesth Analg. 2011;113:523–8. doi:10.1213/ANE.0b013e3182240054.

    PubMed  Google Scholar 

  29. Ameloot K, Palmers PJ, Malbrain ML. The accuracy of noninvasive cardiac output and pressure measurements with finger cuff: a concise review. Curr Opin Crit Care. 2015;21:232–9. doi:10.1097/MCC.0000000000000198.

    Article  PubMed  Google Scholar 

  30. Yin JY, Ho KM. Use of plethysmographic variability index derived from the Massimo® pulse oximeter to predict fluid or preload responsiveness: a systematic review and meta-analysis. Anaesthesia. 2012;67:777–83. doi:10.1111/j.1365-2044.2012.07117.x.

    Article  CAS  PubMed  Google Scholar 

  31. Mehta Y, Chand RK, Sawhney R, Bhise M, Singh A, Trehan N. Cardiac output monitoring: comparison of a new arterial pressure waveform analysis to the bolus thermodilution technique in patients undergoing off-pump coronary artery bypass surgery. J Cardiothorac Vasc Anesth. 2008;22:394–9. doi:10.1053/j.jvca.2008.02.015.

    Article  PubMed  Google Scholar 

  32. Hong DM, Lee JM, Seo JH, Min JJ, Jeon Y, Bahk JH. Pulse pressure variation to predict fluid responsiveness in spontaneously breathing patients: tidal vs. forced inspiratory breathing. Anaesthesia. 2014;69:717–22. doi:10.1111/anae.12678.

    Article  CAS  PubMed  Google Scholar 

  33. Monnet X, Pinsky M, Teboul J-L. FTc is not an accurate predictor of fluid responsiveness. Intensive Care Med. 2006;32:1090–1. doi:10.1007/s00134-006-0158-x.

    Article  Google Scholar 

  34. Schonauer C, Bocchetti A, Barbagallo G, Albanese V, Moraci A. Positioning on surgical table. Eur Spine J. 2004;13(Suppl 1):S50–5. doi:10.1007/s00586-004-0728-y.

    Article  PubMed  PubMed Central  Google Scholar 

  35. Huang L, Critchley LA, Zhang J. Major upper abdominal surgery alters the calibration of bioreactance cardiac output readings, the NICOM, when comparisons are made against suprasternal and esophageal Doppler intraoperatively. Anesth Analg. 2015;121:936–45. doi:10.1213/ANE.0000000000000889.

    Article  PubMed  Google Scholar 

  36. Kupersztych-Hagege E, Teboul JL, Artigas A, Talbot A, Sabatier C, Richard C, Monnet X. Bioreactance is not reliable for estimating cardiac output and the effects of passive leg raising in critically ill patients. Br J Anaesth. 2013;111:961–6. doi:10.1093/bja/aet282.

    Article  CAS  PubMed  Google Scholar 

Download references

Author information

Author notes

    Authors and Affiliations

    1. Department of Anaesthesiology and Pain Medicine, Samsung Medical Centre, Sungkyunkwan University School of Medicine, 81 Irwon-ro, Gangnam-gu, Seoul, 06351, Korea

      Jeong Jin Min, Jong-Hwan Lee, Kwan Young Hong & Soo Joo Choi

    Authors
    1. Jeong Jin Min
      View author publications

      You can also search for this author in PubMed Google Scholar

    2. Jong-Hwan Lee
      View author publications

      You can also search for this author in PubMed Google Scholar

    3. Kwan Young Hong
      View author publications

      You can also search for this author in PubMed Google Scholar

    4. Soo Joo Choi
      View author publications

      You can also search for this author in PubMed Google Scholar

    Corresponding author

    Correspondence to Jong-Hwan Lee.

    Ethics declarations

    Conflict of interest

    None.

    Additional information

    Jong-Hwan Lee and Soo Joo Choi have contributed equally as co-corresponding authors.

    Rights and permissions

    Reprints and permissions

    About this article

    Check for updates. Verify currency and authenticity via CrossMark

    Cite this article

    Min, J.J., Lee, JH., Hong, K.Y. et al. Utility of stroke volume variation measured using non-invasive bioreactance as a predictor of fluid responsiveness in the prone position. J Clin Monit Comput 31, 397–405 (2017). https://doi.org/10.1007/s10877-016-9859-z

    Download citation

    • Received:

    • Accepted:

    • Published:

    • Issue Date:

    • DOI: https://doi.org/10.1007/s10877-016-9859-z

    Keywords

    Search

    Navigation