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21.09.2023 | Original Article

Stroke volume variation and dynamic arterial elastance predict fluid responsiveness even in thoracoscopic esophagectomy: a prospective observational study

verfasst von: Yukiko Hikasa, Satoshi Suzuki, Shunsuke Tanabe, Kazuhiro Noma, Yasuhiro Shirakawa, Toshiyoshi Fujiwara, Hiroshi Morimatsu

Erschienen in: Journal of Anesthesia | Ausgabe 6/2023

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Abstract

Purpose

It remains unknown whether stroke volume variation (SVV), pulse pressure variation (PPV), and dynamic arterial elastance (Ea_dyn) are suitable for monitoring fluid management during thoracoscopic esophagectomy (TE) in the prone position with one-lung ventilation and artificial pneumothorax. Our study aimed to evaluate the accuracy of SVV, PVV, and Ea_dyn in predicting the fluid responsiveness in these patients.

Methods

We recruited 24 patients who had undergone TE. Patients with a mean arterial blood pressure ≤ 65 mmHg received a 200-ml bolus of 6% hydroxyethyl starch over 10 min. Fluid responders showed the stroke volume index ≥ 15% 5 min after the fluid bolus. Receiver operating characteristic (ROC) curves were generated and area under the ROC curve (AUROC) was calculated.

Results

We obtained 61 fluid bolus data points, of which 20 were responders and 41 were non-responders. The median SVV before the fluid bolus in responders was significantly higher than that in non-responders (18% [interquartile range (IQR) 13–21] vs. 12% [IQR 8–15], P = 0.001). Ea_dyn was significantly lower in responders than in non-responders (0.55 [IQR 0.45–0.78] vs. 0.91 [IQR 0.67–1.00], P < 0.001). There was no difference in the PPV between the groups. The AUROC was 0.76 for SVV (95% confidence interval [CI] 0.62–0.89, P = 0.001), 0.56 for PPV (95% CI 0.41–0.71, P = 0.44), and 0.82 for Ea_dyn (95% CI 0.69–0.95, P < 0.001).

Conclusions

SVV and Ea_dyn are reliable parameters for predicting fluid responsiveness in patients undergoing TE.

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Titel: Stroke volume variation and dynamic arterial elastance predict fluid responsiveness even in thoracoscopic esophagectomy: a prospective observational study
verfasst von: Yukiko Hikasa
Satoshi Suzuki
Shunsuke Tanabe
Kazuhiro Noma
Yasuhiro Shirakawa
Toshiyoshi Fujiwara
Hiroshi Morimatsu
Publikationsdatum: 21.09.2023
Verlag: Springer Nature Singapore
Erschienen in: Journal of Anesthesia / Ausgabe 6/2023
Print ISSN: 0913-8668
Elektronische ISSN: 1438-8359
DOI: https://doi.org/10.1007/s00540-023-03256-7

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Stroke volume variation and dynamic arterial elastance predict fluid responsiveness even in thoracoscopic esophagectomy: a prospective observational study