Please use this identifier to cite or link to this item: http://ahro.austin.org.au/austinjspui/handle/1/12390
Title: Pulse pressure variation-guided fluid therapy after cardiac surgery: a pilot before-and-after trial.
Authors: Suzuki, Satoshi;Woinarski, Nicholas C Z;Lipcsey, Miklos;Candal, Cristina Lluch;Schneider, Antoine G;Glassford, Neil J;Eastwood, Glenn M;Bellomo, Rinaldo
Affiliation: Monash University, Faculty of Medicine, Nursing and Health Sciences, Melbourne, Victoria, Australia.
Department of Surgical Sciences, Anaesthesiology and Intensive Care, Uppsala University, Uppsala, Sweden.
Department of Intensive Care, Hospital Universitari Mutua Terrassa, Barcelona, Spain.
Intensive Care Medicine, Universite de Lausanne, Lausanne, Switzerland.
Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia.
Department of Intensive Care, Austin Hospital, Heidelberg, Victoria, Australia; Australian and New Zealand Intensive Care Research Centre, School of Public Health and Preventative Medicine, Monash University, Melbourne, Victoria, Australia. Electronic address: rinaldo.bellomo@austin.org.au.
Issue Date: 7-Aug-2014
Citation: Journal of Critical Care 2014; 29(6): 992-6
Abstract: The aim of this study is to study the feasibility, safety, and physiological effects of pulse pressure variation (PPV)-guided fluid therapy in patients after cardiac surgery.We conducted a pilot prospective before-and-after study during mandatory ventilation after cardiac surgery in a tertiary intensive care unit. We introduced a protocol to deliver a fluid bolus for a PPV≥13% for at least >10 minutes during the intervention period.We studied 45 control patients and 53 intervention patients. During the intervention period, clinicians administered a fluid bolus on 79% of the defined PPV trigger episodes. Median total fluid intake was similar between 2 groups during mandatory ventilation (1297 mL [interquartile range 549-1968] vs 1481 mL [807-2563]; P=.17) and the first 24 hours (3046 mL [interquartile range 2317-3982] vs 3017 mL [2192-4028]; P=.73). After adjusting for several baseline factors, PPV-guided fluid management significantly increased fluid intake during mandatory ventilation (P=.004) but not during the first 24 hours (P=.47). Pulse pressure variation-guided fluid therapy, however, did not significantly affect hemodynamic, renal, and metabolic variables. No serious adverse events were noted.Pulse pressure variation-guided fluid management was feasible and safe during mandatory ventilation after cardiac surgery. However, its advantages may be clinically small.
Internal ID Number: 25220528
URI: http://ahro.austin.org.au/austinjspui/handle/1/12390
DOI: 10.1016/j.jcrc.2014.07.032
URL: http://www.ncbi.nlm.nih.gov/pubmed/25220528
Type: Journal Article
Subjects: Cardiac output
Cardiac surgery
Fluid therapy
Intensive care
Pulse pressure variation
Aged
Analysis of Variance
Blood Pressure.physiology
Cardiac Surgical Procedures
Case-Control Studies
Controlled Before-After Studies
Feasibility Studies
Female
Fluid Therapy.adverse effects.methods
Hemodynamics
Humans
Male
Middle Aged
Pilot Projects
Prospective Studies
Pulse
Respiration, Artificial
Appears in Collections:Journal articles

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