RT Journal Article
T1 Brachial artery peak velocity variation to predict fluid responsiveness in mechanically ventilated patients
A1 Monge García, Manuel Ignacio
A1 Gil Cano, Anselmo
A1 Díaz Monrové, Juan Carlos
K1 Arteria Braquial
K1 Ecocardiografía Doppler
K1 Velocidad de Flujo Sanguineo
K1 Respiración Artificial
K1 Fluidoterapia
K1 Humanos
K1 España
AB INTRODUCTIONAlthough several parameters have been proposed to predict the hemodynamic response to fluid expansion in critically ill patients, most of them are invasive or require the use of special monitoring devices. The aim of this study is to determine whether noninvasive evaluation of respiratory variation of brachial artery peak velocity flow measured using Doppler ultrasound could predict fluid responsiveness in mechanically ventilated patients.METHODSWe conducted a prospective clinical research in a 17-bed multidisciplinary ICU and included 38 mechanically ventilated patients for whom fluid administration was planned due to the presence of acute circulatory failure. Volume expansion (VE) was performed with 500 mL of a synthetic colloid. Patients were classified as responders if stroke volume index (SVi) increased >or= 15% after VE. The respiratory variation in Vpeakbrach (DeltaVpeakbrach) was calculated as the difference between maximum and minimum values of Vpeakbrach over a single respiratory cycle, divided by the mean of the two values and expressed as a percentage. Radial arterial pressure variation (DeltaPPrad) and stroke volume variation measured using the FloTrac/Vigileo system (DeltaSVVigileo), were also calculated.RESULTSVE increased SVi by >or= 15% in 19 patients (responders). At baseline, DeltaVpeakbrach, DeltaPPrad and DeltaSVVigileo were significantly higher in responder than nonresponder patients [14 vs 8%; 18 vs. 5%; 13 vs 8%; P < 0.0001, respectively). A DeltaVpeakbrach value >10% predicted fluid responsiveness with a sensitivity of 74% and a specificity of 95%. A DeltaPPrad value >10% and a DeltaSVVigileo >11% predicted volume responsiveness with a sensitivity of 95% and 79%, and a specificity of 95% and 89%, respectively.CONCLUSIONSRespiratory variations in brachial artery peak velocity could be a feasible tool for the noninvasive assessment of fluid responsiveness in patients with mechanical ventilatory support and acute circulatory failure.TRIAL REGISTRATIONClinicalTrials.gov ID: NCT00890071.
PB BioMed Central Ltd
SN 1364-8535
YR 2009
FD 2009-09-03
LK http://hdl.handle.net/10668/1817
UL http://hdl.handle.net/10668/1817
LA en
NO Monge García MI, Gil Cano A, Díaz Monrové JC. Brachial artery peak velocity variation to predict fluid responsiveness in mechanically ventilated patients. Crit Care.2009 ; 13(5):R142
NO Journal Article;ClinicalTrials.gov ID: NCT00890071
DS RISalud
RD Apr 11, 2025