An Increase in Aortic Blood Flow after an Infusion of 100 ml Colloid over 1 Minute Can Predict Fluid Responsiveness

• DOI: 10.1097/aln.0b013e318229a500
• Publication Date: 2011-07-26T08:29:05Z
• Authors: Laurent Muller; Medhi Toumi; Philippe-Jean Bou...; Béatrice Riu-Poulenc; Guillaume Louart; Damien Candela; Lana Zoric; Carey Suehs; Jean-Emmanuel de ...; Nicolas Molinari; Jean-Yves Lefrant
• Keywords: Pulse pressure; Intravascular volume status

Predicting fluid responsiveness remains a difficult question in hemodynamically unstable patients. The author's objective was to test whether noninvasive assessment by transthoracic echocardiography of subaortic velocity time index (VTI) variation after low volume infusion (100 ml hydroxyethyl starch) can predict responsiveness.Thirty-nine critically ill ventilated and sedated patients with acute circulatory failure were prospectively studied. Subaortic VTI measured before (baseline), 100 starch over 1 min, an additional 400 14 min. authors the (ΔVTI 100) for each patient. Receiver operating characteristic curves generated 100). When available, receiver also pulse pressure central venous pressure.After 500 expansion, increased ≥ 15% 21 (54%) defined as responders. ΔVTI 10% predicted sensitivity specificity 95% 78%, respectively. area under 0.92 (95% CI: 0.78-0.98). In 29 patients, available. this subgroup 100, variation, 0.90 0.74-0.98, P < 0.05), 0.55 0.35-0.73, NS), 0.61 0.41-0.79, respectively.In mechanical ventilation failure, accurately predicts responsiveness.