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Accuracy of stop-cursor method for determining systolic and pulse pressure variation
Laurel Tyler1, Sheryl Greco, Elizabeth Bridges
1University of Washington Medical Center, Seattle, USA.
Summary
Bedside monitor measurements of systolic pressure variation (SPV) and pulse pressure variation (PPV) are accurate for assessing fluid responsiveness. The stop-cursor method provides clinically insignificant differences compared to the gold standard.
Area of Science:
- Critical Care Medicine
- Hemodynamics
- Mechanical Ventilation
Background:
- Functional hemodynamic indicators like SPV and PPV% are vital for fluid responsiveness assessment.
- Previous uncertainty existed regarding the accuracy of bedside monitor measurements for these indicators.
Purpose of the Study:
- To determine the accuracy of SPV, SPV%, and PPV% measurements using a stop-cursor method.
- To compare these measurements against a digitized analog strip, considered the gold standard.
Main Methods:
- A prospective observational study involving 29 adult ICU patients on mechanical ventilation.
- Simultaneous measurement of peak and nadir arterial pressures using the stop-cursor method and a hardcopy strip.
- Averaging indicators over 3 breaths to calculate differences between methods.
Main Results:
- Mean bias for SPV was 0.4 mm Hg, for SPV% was 0.3%, and for PPV% was 1.0%.
- 95% limits of agreement were narrow, indicating good agreement between methods.
- Only one case showed disagreement in fluid response characterization.
Conclusions:
- Statistically small differences were found for SPV and SPV%, but they were not clinically significant.
- The stop-cursor method on bedside monitors provides accurate measurements of functional hemodynamic indicators.
- This method is reliable for assessing fluid responsiveness in critically ill patients.
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Preparation of Equipment:
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