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Evaluation of pulse pressure variation and pleth variability index to predict fluid responsiveness in mechanically ventilated isoflurane-anesthetized dogs.
- Source :
-
Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001) [J Vet Emerg Crit Care (San Antonio)] 2018 Jul; Vol. 28 (4), pp. 301-309. Date of Electronic Publication: 2018 Jun 13. - Publication Year :
- 2018
-
Abstract
- Objective: To evaluate whether pulse pressure variation (PPV) and pleth variability index (PVI) are more accurate than central venous pressure (CVP) for predicting fluid responsiveness in mechanically ventilated isoflurane-anesthetized dogs after premedication with acepromazine.<br />Design: Prospective experimental trial.<br />Setting: University teaching hospital.<br />Animals: Twelve Harrier hound dogs.<br />Interventions: Each dog was anesthetized and had a fluid challenge performed. This was repeated 4 weeks later for a total of 24 fluid challenges. After premedication with intramuscular acepromazine, anesthesia was induced with propofol and maintained with isoflurane. The dogs were mechanically ventilated with constant settings. The fluid challenge consisted of 10 mL/kg of 6% hydroxyethyl starch intravenously over 13 minutes.<br />Measurements and Main Results: Before and after the fluid challenge, PPV, PVI, CVP, and other hemodynamics were recorded. Change in velocity time integral of pulmonary arterial blood flow by echocardiography was calculated as an indication of change in stroke volume. A fluid responder was defined as an increase in velocity time integral ≥ 15%. Receiver operator characteristic (ROC) curves were used to determine cutoff values. Areas under ROC curve were calculated and compared. Dogs responded on 14 fluid challenges and did not on 10. Cutoff values for PPV and PVI were 11% (sensitivity 79%; specificity 80%) and 9.3% (sensitivity 86%; specificity 70%), respectively. The areas under the ROC curve of PPV [0.85, 95% confidence interval (CI): 0.70-1.00, P = 0.038] and PVI (0.84, 95% CI: 0.68-1.00, P = 0.043) were significantly higher than CVP (0.56, 95% CI: 0.32-0.81).<br />Conclusions: PPV and PVI predicted fluid responsiveness more accurately than CVP and may be useful to guide fluid administration in mechanically ventilated isoflurane-anesthetized dogs after premedication with acepromazine.<br /> (© Veterinary Emergency and Critical Care Society 2018.)
- Subjects :
- Anesthesia veterinary
Anesthetics, Inhalation administration & dosage
Animals
Female
Fluid Therapy veterinary
Isoflurane administration & dosage
Male
Plethysmography veterinary
Prospective Studies
Pulmonary Artery diagnostic imaging
ROC Curve
Respiration, Artificial veterinary
Sensitivity and Specificity
Anesthetics, Inhalation pharmacology
Blood Pressure drug effects
Dogs physiology
Hemodynamics drug effects
Isoflurane pharmacology
Pulmonary Artery physiology
Subjects
Details
- Language :
- English
- ISSN :
- 1476-4431
- Volume :
- 28
- Issue :
- 4
- Database :
- MEDLINE
- Journal :
- Journal of veterinary emergency and critical care (San Antonio, Tex. : 2001)
- Publication Type :
- Academic Journal
- Accession number :
- 29898246
- Full Text :
- https://doi.org/10.1111/vec.12728