Pulse Pressure Variation, Spontaneously Breathing
Conditions
Brief summary
The investigators hypothesized that pulse pressure variation (PPV) could predict fluid responsiveness in spontaneously breathing patients undergoing anesthesia induction.
Detailed description
Pulse pressure variation (PPV) is known to be a dynamic indicator to predict fluid responsiveness in mechanically ventilating patients. PPV is generated by cardiopulmonary interaction with respiratory cycles. In spontaneous breathing, the cardiopulmonary interaction may lead to PPV by inverted manner. In this study, the investigators will evaluate the ability of PPV to predict fluid responsiveness in spontaneously breathing patients. Before induction of anesthesia, radial artery cannulation is performed, and FloTrac/Vigileo (Edwards Lifesciences Corp., Irvine, USA) system is connected. And then, the investigators will measure baseline data including invasive blood pressure, pulse pressure, cardiac index, stroke volume variation in two different conditions: during tidal spontaneous breathing and during forced spontaneous breathing. All hemodynamic measurement will be repeated after infusion of fluid using 6mL/kg of hydroxyethyl starch solution (Voluven), and will be averaged over 3 minutes. Patients whose cardiac index increased by \>15% to fluid infusion is defined as responders. The investigators will compare the hemodynamic parameters between responders and non-responders. To evaluate the ability to predict volume responsiveness, receiver operating characteristics curves of the PPV will be calculated.
Interventions
PROCEDUREHydroxyethyl starch solution (Voluven) infusion
fluid loading will be performed by hydroxyethyl starch solution (Voluven), at 6 mL/kg
Sponsors
Seoul National University Hospital
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
QUADRUPLE (Subject, Caregiver, Investigator, Outcomes Assessor)
Eligibility
Sex/Gender
ALL
Age
18 Years to 80 Years
Healthy volunteers
No
Inclusion criteria
* patients undergoing thoracic surgery
Exclusion criteria
* preoperative arrhythmia * left ventricular ejection fraction \<40% * intra-cardiac valve disease * intra-cardiac shunt * pulmonary artery hypertension * severe peripheral vascular obstructive disease * decreased pulmonary function
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| pulse pressure variation | three respiratory cycles, an expected average of 30 seconds |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| hemodynamic parameters | before and after fluid loading, 1 mimute | systolic blood pressure (SBP), dyastolic BP, mean BP, heart rate, cardiac index, stroke volume varation |
Countries
South Korea
Outcome results
None listed