Pulse pressure variation-guided fluid therapy after cardiac surgery: A pilot before-and-after trial

Pulse pressure variation-guided fluid therapy after cardiac surgery : A pilot before-and-after trial

Suzuki, Satoshi (author)

Woinarski, Nicholas C. Z. (author)

Lipcsey, Miklós (author): Uppsala universitet,Anestesiologi och intensivvård

Candal, Cristina Lluch (author)

Schneider, Antoine G. (author)

Glassford, Neil J. (author)

Eastwood, Glenn M. (author)

Bellomo, Rinaldo (author)

(creator_code:org_t)

Elsevier BV, 2014
2014
English.
In: Journal of critical care. - : Elsevier BV. - 0883-9441 .- 1557-8615. ; 29:6, s. 992-996

Related links:: https://urn.kb.se/re...; show more...; https://doi.org/10.1...; show less...

Abstract Subject headings

Purpose: The aim of this study is to study the feasibility, safety, and physiological effects of pulse pressure variation (PPV)-guided fluid therapy in patients after cardiac surgery. Materials and methods: We conducted a pilot prospective before-and-after study during mandatory ventilation after cardiac surgery in a tertiary intensive care unit. We introduced a protocol to deliver a fluid bolus for a PPV >= 13% for at least >10 minutes during the intervention period. Results: We studied 45 control patients and 53 intervention patients. During the intervention period, clinicians administered a fluid bolus on 79% of the defined PPV trigger episodes. Median total fluid intake was similar between 2 groups during mandatory ventilation (1297 mL[interquartile range 549-1968] vs 1481 mL [807-2563]; P =. 17) and the first 24 hours (3046 mL [interquartile range 2317-3982] vs 3017 mL [2192-4028]; P = .73). After adjusting for several baseline factors, PPV-guided fluid management significantly increased fluid intake during mandatory ventilation (P = .004) but not during the first 24 hours (P = .47). Pulse pressure variation-guided fluid therapy, however, did not significantly affect hemodynamic, renal, and metabolic variables. No serious adverse events were noted. Conclusions: Pulse pressure variation-guided fluid management was feasible and safe during mandatory ventilation after cardiac surgery. However, its advantages may be clinically small.

By the author/editor: Suzuki, Satoshi; Woinarski, Nicho ...; Lipcsey, Miklós; Candal, Cristina ...; Schneider, Antoi ...; Glassford, Neil ...; show more...; Eastwood, Glenn ...; Bellomo, Rinaldo; show less...

About the subject

MEDICAL AND HEALTH SCIENCES: MEDICAL AND HEAL ...; and Clinical Medicin ...; and Anesthesiology a ...

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