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Esophageal Doppler monitoring predicts fluid responsiveness in critically ill ventilated patients

Monnet, X and Rienzo, M and Osman, D and Anguel, N and Richard, C and Pinsky, MR and Teboul, JL (2005) Esophageal Doppler monitoring predicts fluid responsiveness in critically ill ventilated patients. Intensive Care Medicine, 31 (9). 1195 - 1201. ISSN 0342-4642

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Abstract

Objective: To test whether fluid responsiveness can be predicted by the respiratory variation in aortic blood flow and/or the flow time corrected for heart rate monitored with esophageal Doppler. Design and setting: Prospective study in a 24-bed medical intensive care unit of a university hospital. Patients: 38 mechanically ventilated patients with sinus rhythm and without spontaneous breathing activity in whom volume expansion was planned. Interventions: The aortic blood flow was measured using an esophageal Doppler monitoring device before and after fluid infusion (500 ml NaCl 0.9% over 10 min). The variation in aortic blood flow over a respiratory cycle between its minimal and maximal values was calculated. The flow time was also measured. Measurements and results: Aortic blood flow increased by at least 15% after volume expansion in 20 patients (defined as responders). Before fluid infusion the respiratory variation in aortic flow was higher in responders than in nonresponders (28±12% vs. 12±5%). It significantly decreased after volume expansion (18±11%) in responders only. A respiratory variation in aortic flow before volume expansion of at least 18% predicted fluid responsiveness with a sensitivity of 90% and a specificity of 94%. Flow time increased with fluid infusion in responders and nonresponders. A flow time corrected for heart rate below 277 ms predicted fluid responsiveness with a sensitivity of 55% and a specificity of 94%. The area under the ROC curve generated for variation in aortic blood flow ABF was greater than that generated for flow time. Conclusions: The respiratory variation in aortic blood flow reliably predicts fluid responsiveness in patients with sinus rhythm and without breathing activity. © Springer-Verlag 2005.


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Details

Item Type: Article
Status: Published
Creators/Authors:
CreatorsEmailPitt UsernameORCID
Monnet, X
Rienzo, M
Osman, D
Anguel, N
Richard, C
Pinsky, MRpinsky@pitt.eduPINSKY
Teboul, JL
Date: 1 September 2005
Date Type: Publication
Journal or Publication Title: Intensive Care Medicine
Volume: 31
Number: 9
Page Range: 1195 - 1201
DOI or Unique Handle: 10.1007/s00134-005-2731-0
Schools and Programs: School of Medicine > Critical Care Medicine
Refereed: Yes
ISSN: 0342-4642
PubMed ID: 16059723
Date Deposited: 05 Apr 2012 21:55
Last Modified: 04 Feb 2019 15:57
URI: http://d-scholarship.pitt.edu/id/eprint/11582

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