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British Journal of Anaesthesia
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License: Elsevier Non-Commercial
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British Journal of Anaesthesia
Article . 2014 . Peer-reviewed
License: Elsevier Non-Commercial
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End-expiratory occlusion manoeuvre does not accurately predict fluid responsiveness in the operating theatre

Authors: P-G, Guinot; J, Godart; B, de Broca; E, Bernard; E, Lorne; H, Dupont;

End-expiratory occlusion manoeuvre does not accurately predict fluid responsiveness in the operating theatre

Abstract

The objective of this study was to determine whether assessment of stroke volume (SV) and measurement of exhaled end-tidal carbon dioxide [Formula: see text] during an end-expiratory occlusion (EEO) test can predict fluid responsiveness in the operating theatre.Forty-two subjects monitored by oesophageal Doppler who required i.v. fluids during surgery were studied. Haemodynamic variables [heart rate, non-invasive arterial pressure, SV, cardiac output (CO), respiratory variation of SV (ΔrespSV), variation of SV during EEO, and E'(CO₂) were measured at baseline, during EEO (Δ(EEO)), and after fluid expansion. Responders were defined by an increase in SV over 15% after infusion of 500 ml of crystalloid solution.Of the 42 subjects, 28 (67%) responded to fluid infusion. A cut-off of >2.3% ΔSV(EEO) predicted fluid responsiveness with an area under the receiver-operating characteristic (AUC) curve of 0.78 [95% confidence interval (95% CI): 0.63-0.89, P=0.003]. The AUC of ΔrespSV was 0.89 (95% CI: 0.76-0.97, P<0.001). With an AUC of 0.68 (95% CI: 0.51-0.81, P=0.07), E'(CO₂)(EEO) was poorly predictive of fluid responsiveness.ΔSV(EEO) and ΔE'(CO₂) were unable to accurately predict fluid responsiveness during surgery.

Keywords

Male, Operating Rooms, Respiration, Hemodynamics, Reproducibility of Results, Stroke Volume, Crystalloid Solutions, Carbon Dioxide, Middle Aged, Respiration, Artificial, Echocardiography, Doppler, ROC Curve, Exhalation, Monitoring, Intraoperative, Fluid Therapy, Humans, Arterial Pressure, Female, Cardiac Output, Isotonic Solutions

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selected citations
These citations are derived from selected sources.
This is an alternative to the "Influence" indicator, which also reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Citations provided by BIP!
popularity
This indicator reflects the "current" impact/attention (the "hype") of an article in the research community at large, based on the underlying citation network.
BIP!Popularity provided by BIP!
influence
This indicator reflects the overall/total impact of an article in the research community at large, based on the underlying citation network (diachronically).
BIP!Influence provided by BIP!
impulse
This indicator reflects the initial momentum of an article directly after its publication, based on the underlying citation network.
BIP!Impulse provided by BIP!
40
Top 10%
Top 10%
Top 10%
hybrid