A comparative study of pulse pressure variation, stroke volume variation and central venous pressure in patients undergoing kidney transplantation
Introduction: Optimal intraoperative fluid management guided by central venous pressure (CVP), a traditional intravascular volume status indicator, has improved transplanted graft function during kidney transplantation (KT). Pulse pressure variation (PPV) and stroke volume variation (SVV) – dynamic...
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| Format: | Article |
| Language: | English |
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Wolters Kluwer – Medknow Publications
2022-12-01
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| Series: | Singapore Medical Journal |
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| Online Access: | https://journals.lww.com/10.11622/smedj.2021221 |
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| _version_ | 1823861066465017856 |
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| author | Kyung Mi Kim Gaab Soo Kim Minsoo Han |
| author_facet | Kyung Mi Kim Gaab Soo Kim Minsoo Han |
| author_sort | Kyung Mi Kim |
| collection | DOAJ |
| description | Introduction:
Optimal intraoperative fluid management guided by central venous pressure (CVP), a traditional intravascular volume status indicator, has improved transplanted graft function during kidney transplantation (KT). Pulse pressure variation (PPV) and stroke volume variation (SVV) – dynamic preload indexes – are robust predictors of fluid responsiveness. This study aimed to compare the accuracy of PPV and CVP against SVV in predicting fluid responsiveness in terms of cost-effectiveness after a standardised empiric volume challenge in KT patients.
Methods:
36 patients undergoing living-donor KT were analysed. PPV, SVV, CVP and cardiac index (CI) were measured before and after fluid loading with a hydroxyethyl starch solution (7 mL/kg of ideal body weight). Patients were classified as responders (n = 12) or non-responders (n = 24) to fluid loading when CI increases were ≥10% or <10%, respectively. The ability of PPV, SVV and CVP to predict fluid responsiveness was assessed using receiver operating characteristic (ROC) curves.
Results:
SVV and CVP measured before fluid loading were correlated with changes in CI caused by fluid expansion (r = 0.33, P = 0.049 and r = −0.37, P = 0.026) in contrast to PPV (r = 0.14, P = 0.429). The ROC analysis showed that SVV and CVP predicted response to volume loading (area under the ROC curve = 0.781 and 0.727, respectively; P < 0.05).
Conclusion:
Under the conditions of our study, SVV and CVP exhibited similar performance in predicting fluid responsiveness and could inform fluid management during KT as compared with PPV. |
| format | Article |
| id | doaj-art-de145c89ec4942c293dc322cc1d86e6c |
| institution | Kabale University |
| issn | 0037-5675 2737-5935 |
| language | English |
| publishDate | 2022-12-01 |
| publisher | Wolters Kluwer – Medknow Publications |
| record_format | Article |
| series | Singapore Medical Journal |
| spelling | doaj-art-de145c89ec4942c293dc322cc1d86e6c2025-02-10T05:49:10ZengWolters Kluwer – Medknow PublicationsSingapore Medical Journal0037-56752737-59352022-12-01631273173910.11622/smedj.2021221A comparative study of pulse pressure variation, stroke volume variation and central venous pressure in patients undergoing kidney transplantationKyung Mi KimGaab Soo KimMinsoo HanIntroduction: Optimal intraoperative fluid management guided by central venous pressure (CVP), a traditional intravascular volume status indicator, has improved transplanted graft function during kidney transplantation (KT). Pulse pressure variation (PPV) and stroke volume variation (SVV) – dynamic preload indexes – are robust predictors of fluid responsiveness. This study aimed to compare the accuracy of PPV and CVP against SVV in predicting fluid responsiveness in terms of cost-effectiveness after a standardised empiric volume challenge in KT patients. Methods: 36 patients undergoing living-donor KT were analysed. PPV, SVV, CVP and cardiac index (CI) were measured before and after fluid loading with a hydroxyethyl starch solution (7 mL/kg of ideal body weight). Patients were classified as responders (n = 12) or non-responders (n = 24) to fluid loading when CI increases were ≥10% or <10%, respectively. The ability of PPV, SVV and CVP to predict fluid responsiveness was assessed using receiver operating characteristic (ROC) curves. Results: SVV and CVP measured before fluid loading were correlated with changes in CI caused by fluid expansion (r = 0.33, P = 0.049 and r = −0.37, P = 0.026) in contrast to PPV (r = 0.14, P = 0.429). The ROC analysis showed that SVV and CVP predicted response to volume loading (area under the ROC curve = 0.781 and 0.727, respectively; P < 0.05). Conclusion: Under the conditions of our study, SVV and CVP exhibited similar performance in predicting fluid responsiveness and could inform fluid management during KT as compared with PPV.https://journals.lww.com/10.11622/smedj.2021221central venous pressurefluid therapykidney transplantationpulse pressure variationstroke volume variation |
| spellingShingle | Kyung Mi Kim Gaab Soo Kim Minsoo Han A comparative study of pulse pressure variation, stroke volume variation and central venous pressure in patients undergoing kidney transplantation Singapore Medical Journal central venous pressure fluid therapy kidney transplantation pulse pressure variation stroke volume variation |
| title | A comparative study of pulse pressure variation, stroke volume variation and central venous pressure in patients undergoing kidney transplantation |
| title_full | A comparative study of pulse pressure variation, stroke volume variation and central venous pressure in patients undergoing kidney transplantation |
| title_fullStr | A comparative study of pulse pressure variation, stroke volume variation and central venous pressure in patients undergoing kidney transplantation |
| title_full_unstemmed | A comparative study of pulse pressure variation, stroke volume variation and central venous pressure in patients undergoing kidney transplantation |
| title_short | A comparative study of pulse pressure variation, stroke volume variation and central venous pressure in patients undergoing kidney transplantation |
| title_sort | comparative study of pulse pressure variation stroke volume variation and central venous pressure in patients undergoing kidney transplantation |
| topic | central venous pressure fluid therapy kidney transplantation pulse pressure variation stroke volume variation |
| url | https://journals.lww.com/10.11622/smedj.2021221 |
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