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Do changes in perfusion index reflect changes in stroke volume during preload-modifying manoeuvres?

dc.rights.licenseauthentificationen_US
hal.structure.identifierBordeaux population health [BPH]
dc.contributor.authorDE COURSON DE LA VILLENEUVE, Hugues
dc.contributor.authorMICHARD, Frederic
dc.contributor.authorCHAVIGNIER, Camille
dc.contributor.authorVERCHERE, Eric
dc.contributor.authorNOUETTE-GAULAIN, Karine
hal.structure.identifierBiologie des maladies cardiovasculaires = Biology of Cardiovascular Diseases
dc.contributor.authorBIAIS, Matthieu
dc.date.accessioned2020-11-10T10:40:44Z
dc.date.available2020-11-10T10:40:44Z
dc.date.issued2019-12
dc.identifier.issn1573-2614en_US
dc.identifier.urihttps://oskar-bordeaux.fr/handle/20.500.12278/12190
dc.description.abstractEnChanges in stroke volume (deltaSV) induced by a lung recruitment manoeuvre (LRM) have been shown to accurately predict fluid responsiveness during protective mechanical ventilation. Cardiac output monitors are used in a limited number of surgical patients. In contrast, all patients are monitored with a pulse oximeter, that may enable the continuous monitoring of a peripheral perfusion index (PI). We postulated that changes in PI (deltaPI) may reflect deltaSV during brief modifications of cardiac preload. We studied 47 patients undergoing neurosurgery and ventilated with a tidal volume of 6-8 ml/kg. All patients were monitored with a pulse contour system enabling the continuous monitoring of SV and with a pulse oximeter enabling the continuous monitoring of PI. LRMs were performed by increasing airway pressure up to 30 cmH20 for 30 s. Fluid loads (250 ml of saline 0.9% in 10 min) were performed only in patients who experienced a deltaSV \textgreater 30% during LRMs (potential fluid responders). LRMs induced a 26% decrease in SV (p \textless 0.05) and a 27% decrease in PI (p \textless 0.05). We observed a fair relationship between deltaPI and deltaSV (r2 = 0.34). A deltaPI ≥ 26% predicted a deltaSV \textgreater 30% with a sensitivity of 83% and a specificity of 78% (AUC = 0.84, 95%CI 0.71-0.93). 24 patients experienced a deltaSV \textgreater 30% and subsequently received fluid. Fluid loads induced a 16% increase in SV and a 17% increase in PI, but fluid-induced deltaPI and deltaSV were weakly correlated (r2 = 0.19). In neurosurgical patients, we conclude that deltaPI may be used as a surrogate for deltaSV during LRMs but not during fluid loading.
dc.language.isoENen_US
dc.subjectArticle CLINIQUE
dc.subject.enCardiac output
dc.subject.enFluid responsiveness
dc.subject.enLung recruitment manoeuvre
dc.subject.enPerfusion index
dc.subject.enPulse oximeter
dc.title.enDo changes in perfusion index reflect changes in stroke volume during preload-modifying manoeuvres?
dc.typeArticle de revueen_US
dc.identifier.doi10.1007/s10877-019-00445-2en_US
dc.subject.halSciences du Vivant [q-bio]/Médecine humaine et pathologieen_US
dc.identifier.pubmed31853812en_US
bordeaux.journalJournal of Clinical Monitoring and Computingen_US
bordeaux.hal.laboratoriesBiologie des maladies cardiovasculaires - U1034en_US
bordeaux.institutionUniversité de Bordeauxen_US
bordeaux.institutionINSERM
bordeaux.teamBIOSTAT_BPH
bordeaux.peerReviewedouien_US
bordeaux.inpressnonen_US
hal.exportfalse
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