Determination of the cut-off value for estimated stroke volume variation as a predictor of fluid responsiveness

Estimated stroke volume variation (esSVV) serves as a noninvasive indicator of fluid responsiveness measured using the estimated continuous cardiac output (esCCO) system. However, the cutoff value for esSVV has not yet been established. The aim of this study was to determine the cutoff value for esSVV.

In this prospective observational study, patients scheduled for general anesthesia were included. Following anesthesia induction, the esCCO system was calibrated, and the blood pressure at that time was recorded as the baseline value. A fluid challenge was initiated when the blood pressure decreased by > 10% from the baseline systolic pressure, at least 5 min after calibration. A colloidal solution (300 ml) was administered over a 15-min period. The esSV measured 5 min before infusion was compared to the maximal esSV recorded 5 min after completing the infusion. Moreover, patients with an esSV increase of > 10% were categorized into the responder group, whereas those with a < 10% increase were classified into the non-responder group. A receiver operating characteristic curve was generated, and the area under the curve (AUC) was calculated.

We identified 43 and 40 cases of esSVV and SVV, respectively. The AUC for esSVV was 0.73, with a threshold value of 7.3%, whereas that for SVV was 0.65, with a threshold value of 12%.

The established cutoff value for esSVV was 7.3%. Hence, it may be a useful tool for managing circulation, particularly given that its cutoff value has now been determined.

University Hospital Medical Information Network (UMIN) Clinical Trials Registry (UMIN register no. UMIN000049595 on November 24, 2022).