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01.10.2005 | Original

Stroke output variations calculated by esophageal Doppler is a reliable predictor of fluid response

verfasst von: Fabrice Vallée, Olivier Fourcade, Olivier De Soyres, Olivier Angles, Pascale Sanchez-Verlaan, Fabien Pillard, Nadia Smail, Michel Olivier, Michèle Genestal, Kamran Samii

Erschienen in: Intensive Care Medicine | Ausgabe 10/2005

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Abstract

Objective

Esophageal Doppler allows continuous monitoring of stroke volume index (SVI) and corrected flow time (FTc). We hypothesized that variations in stroke output index SOI (SVI/FTc) during volume expansion can predict the hemodynamic response to subsequent fluid loading better than the static values.

Design and setting

Prospective study in the intensive care unit of a university hospital.

Patients

Fifty-one patients with circulatory failure were monitored by esophageal Doppler.

Interventions

Patients who responded to a first fluid challenge received a second one. Patients who responded to both were classified as responders-responders, and those who did not respond to the second as responders-nonresponders. In these two groups we compared ΔSVI, ΔFTc, and ΔSOI during each fluid challenge and also static values at the end of each fluid challenge.

Measurements and results

After the first fluid challenge ΔSOI and ΔSVI were significantly higher in patients who responded to subsequent volume expansion than in patients who no longer responded. ROC curves showed that ΔSOI was a better predictor of fluid responsiveness than ΔSVI. During volume expansion a ΔSOI value of 11% discriminated between responders and nonresponders to subsequent volume expansion with a sensitivity of 91% and a specificity of 97%. There was no significant difference between the two groups for FTc value at the end of first fluid challenge.

Conclusions

Analysis of ΔSOI during fluid challenge predicts response to subsequent fluid challenge and FTc is not a reliable indicator of cardiac preload.

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Titel: Stroke output variations calculated by esophageal Doppler is a reliable predictor of fluid response
verfasst von: Fabrice Vallée
Olivier Fourcade
Olivier De Soyres
Olivier Angles
Pascale Sanchez-Verlaan
Fabien Pillard
Nadia Smail
Michel Olivier
Michèle Genestal
Kamran Samii
Publikationsdatum: 01.10.2005
Verlag: Springer-Verlag
Erschienen in: Intensive Care Medicine / Ausgabe 10/2005
Print ISSN: 0342-4642
Elektronische ISSN: 1432-1238
DOI: https://doi.org/10.1007/s00134-005-2768-0

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Stroke output variations calculated by esophageal Doppler is a reliable predictor of fluid response