Related Experiment Video
Updated: Oct 1, 2025
05:07
Author Spotlight: Improved Localization and Monitoring of Coronary Flow Reserve Using Modified PLAX View in Mice
Published on: August 25, 2023
1.4K
Invasive and Non-invasive Dynamic Parameters to Predict Fluid Responsiveness After Off-pump Coronary Surgery
Evgeniia V Fot1, Natalia N Izotova1, Aleksei A Smetkin1
1Department of Anaesthesiology and Intensive Care Medicine, Northern State Medical University, Arkhangelsk, Russian Federation.
Turkish Journal of Anaesthesiology and Reanimation
|March 8, 2022
Summary
Dynamic parameters like pulse pressure variation (PPV) and stroke volume variation predict fluid responsiveness in patients after off-pump coronary artery bypass grafting (CABG). These measures can guide early postoperative fluid therapy.
Area of Science:
- Cardiovascular Surgery
- Critical Care Medicine
- Physiology
Background:
- Fluid responsiveness assessment is crucial in post-cardiac surgery patients.
- Off-pump coronary artery bypass grafting (CABG) presents unique hemodynamic challenges.
- Optimizing fluid therapy post-CABG can improve patient outcomes.
Purpose of the Study:
- To evaluate the predictive accuracy of invasive and non-invasive dynamic parameters for fluid responsiveness.
- To assess these parameters in patients undergoing off-pump CABG.
Main Methods:
- A prospective observational study involving 32 adult patients post-off-pump CABG.
- Fluid responsiveness was determined by a standard fluid challenge test (≥15% increase in cardiac index).
- Dynamic parameters measured included pulse pressure variation (PPVPiCCO, PPVNK), stroke volume variation, heart-lung interaction index, and plethysmogram variability index.
Main Results:
- Fluid responders showed significantly higher baseline values for stroke volume variation, PPVPiCCO, PPVNK, and heart-lung interaction index (P < .05).
- Predictive ability for fluid responsiveness was demonstrated by PPVPiCCO (AUC 0.84), stroke volume variation (AUC 0.77), PPVNK (AUC 0.71), and heart-lung interaction index (AUC 0.77).
- Plethysmogram variability index showed no predictive value (AUC 0.5, P =.1).
Conclusions:
- Invasive (PPV, SVV) and non-invasive (heart-lung interaction index) dynamic parameters effectively predict fluid responsiveness post-off-pump CABG.
- These dynamic indices can guide fluid management in the early postoperative period.
- This supports the use of dynamic parameters for personalized fluid therapy in this patient population.
