Evaluation of corrected flow time in oesophageal Doppler as a predictor of fluid responsiveness

J. H. Lee, J. T. Kim, Seung-Zhoo Yoon, Y. J. Lim, Yunseok Jeon, J. H. Bahk, C. S. Kim

Research output: Contribution to journalArticle

80 Citations (Scopus)

Abstract

Background. Corrected flow time (FTc) by oesophageal Doppler is considered to be a 'static' preload index. We evaluated the ability of FTc to predict fluid responsiveness and compared this with the abilities of other preload indices, such as pulse pressure variation (PPV), central venous pressure (CVP), and left ventricular end-diastolic area index (LVEDAI). Methods. Twenty neurosurgical patients were studied. After induction of anaesthesia, FTc, PPV, LVEDAI, CVP, and stroke volume index (SVI) were measured before and 12 min after fluid loading with 6% hydroxyethyl starch solution (7 ml kg-1). Responders and non-responders were defined as those patients with an SVI increase ≥10% or <10% after fluid loading, respectively. Pearson's correlation was used to assess correlations between changes in SVI and initial haemodynamic variables. Receiver operating characteristic (ROC) curves were constructed and compared to evaluate the overall performance of preload indices (FTc, PPV, LVEDAI, and CVP) in terms of predicting fluid responsiveness. Results. FTc and PPV before fluid loading differed between responders (n = 11) and non-responders (n = 9), and correlated with changes in SVI (r = -0.515 and r = 0.696, respectively), which was opposite to that observed for CVP or LVEDAI. Areas under ROC curves for FTc [0.944 (SD 0.058)] and PPV [0.909 (0.069)] were significantly greater than those for CVP [0.540 (0.133), P < 0.001] and LVEDAI [0.495 (0.133), P < 0.001]. The optimal threshold value given by ROC analysis was 357 ms for FTc. Conclusions. In this study, FTc predicted fluid responsiveness. However, FTc should be used in conjunction with other clinical information.

Original languageEnglish
Pages (from-to)343-348
Number of pages6
JournalBritish Journal of Anaesthesia
Volume99
Issue number3
DOIs
Publication statusPublished - 2007 Sep 1
Externally publishedYes

Fingerprint

Central Venous Pressure
Stroke Volume
Blood Pressure
ROC Curve
Starch
Anesthesia
Hemodynamics

Keywords

  • Cardiac output
  • Fluid balance
  • Heart
  • Monitoring, arterial pressure
  • Monitoring, cardiopulmonary
  • Monitoring, intraoperative

ASJC Scopus subject areas

  • Anesthesiology and Pain Medicine

Cite this

Evaluation of corrected flow time in oesophageal Doppler as a predictor of fluid responsiveness. / Lee, J. H.; Kim, J. T.; Yoon, Seung-Zhoo; Lim, Y. J.; Jeon, Yunseok; Bahk, J. H.; Kim, C. S.

In: British Journal of Anaesthesia, Vol. 99, No. 3, 01.09.2007, p. 343-348.

Research output: Contribution to journalArticle

Lee, J. H. ; Kim, J. T. ; Yoon, Seung-Zhoo ; Lim, Y. J. ; Jeon, Yunseok ; Bahk, J. H. ; Kim, C. S. / Evaluation of corrected flow time in oesophageal Doppler as a predictor of fluid responsiveness. In: British Journal of Anaesthesia. 2007 ; Vol. 99, No. 3. pp. 343-348.
@article{19a2a6fe6db8401ab866b59bc78c1c9a,
title = "Evaluation of corrected flow time in oesophageal Doppler as a predictor of fluid responsiveness",
abstract = "Background. Corrected flow time (FTc) by oesophageal Doppler is considered to be a 'static' preload index. We evaluated the ability of FTc to predict fluid responsiveness and compared this with the abilities of other preload indices, such as pulse pressure variation (PPV), central venous pressure (CVP), and left ventricular end-diastolic area index (LVEDAI). Methods. Twenty neurosurgical patients were studied. After induction of anaesthesia, FTc, PPV, LVEDAI, CVP, and stroke volume index (SVI) were measured before and 12 min after fluid loading with 6{\%} hydroxyethyl starch solution (7 ml kg-1). Responders and non-responders were defined as those patients with an SVI increase ≥10{\%} or <10{\%} after fluid loading, respectively. Pearson's correlation was used to assess correlations between changes in SVI and initial haemodynamic variables. Receiver operating characteristic (ROC) curves were constructed and compared to evaluate the overall performance of preload indices (FTc, PPV, LVEDAI, and CVP) in terms of predicting fluid responsiveness. Results. FTc and PPV before fluid loading differed between responders (n = 11) and non-responders (n = 9), and correlated with changes in SVI (r = -0.515 and r = 0.696, respectively), which was opposite to that observed for CVP or LVEDAI. Areas under ROC curves for FTc [0.944 (SD 0.058)] and PPV [0.909 (0.069)] were significantly greater than those for CVP [0.540 (0.133), P < 0.001] and LVEDAI [0.495 (0.133), P < 0.001]. The optimal threshold value given by ROC analysis was 357 ms for FTc. Conclusions. In this study, FTc predicted fluid responsiveness. However, FTc should be used in conjunction with other clinical information.",
keywords = "Cardiac output, Fluid balance, Heart, Monitoring, arterial pressure, Monitoring, cardiopulmonary, Monitoring, intraoperative",
author = "Lee, {J. H.} and Kim, {J. T.} and Seung-Zhoo Yoon and Lim, {Y. J.} and Yunseok Jeon and Bahk, {J. H.} and Kim, {C. S.}",
year = "2007",
month = "9",
day = "1",
doi = "10.1093/bja/aem179",
language = "English",
volume = "99",
pages = "343--348",
journal = "British Journal of Anaesthesia",
issn = "0007-0912",
publisher = "Oxford University Press",
number = "3",

}

TY - JOUR

T1 - Evaluation of corrected flow time in oesophageal Doppler as a predictor of fluid responsiveness

AU - Lee, J. H.

AU - Kim, J. T.

AU - Yoon, Seung-Zhoo

AU - Lim, Y. J.

AU - Jeon, Yunseok

AU - Bahk, J. H.

AU - Kim, C. S.

PY - 2007/9/1

Y1 - 2007/9/1

N2 - Background. Corrected flow time (FTc) by oesophageal Doppler is considered to be a 'static' preload index. We evaluated the ability of FTc to predict fluid responsiveness and compared this with the abilities of other preload indices, such as pulse pressure variation (PPV), central venous pressure (CVP), and left ventricular end-diastolic area index (LVEDAI). Methods. Twenty neurosurgical patients were studied. After induction of anaesthesia, FTc, PPV, LVEDAI, CVP, and stroke volume index (SVI) were measured before and 12 min after fluid loading with 6% hydroxyethyl starch solution (7 ml kg-1). Responders and non-responders were defined as those patients with an SVI increase ≥10% or <10% after fluid loading, respectively. Pearson's correlation was used to assess correlations between changes in SVI and initial haemodynamic variables. Receiver operating characteristic (ROC) curves were constructed and compared to evaluate the overall performance of preload indices (FTc, PPV, LVEDAI, and CVP) in terms of predicting fluid responsiveness. Results. FTc and PPV before fluid loading differed between responders (n = 11) and non-responders (n = 9), and correlated with changes in SVI (r = -0.515 and r = 0.696, respectively), which was opposite to that observed for CVP or LVEDAI. Areas under ROC curves for FTc [0.944 (SD 0.058)] and PPV [0.909 (0.069)] were significantly greater than those for CVP [0.540 (0.133), P < 0.001] and LVEDAI [0.495 (0.133), P < 0.001]. The optimal threshold value given by ROC analysis was 357 ms for FTc. Conclusions. In this study, FTc predicted fluid responsiveness. However, FTc should be used in conjunction with other clinical information.

AB - Background. Corrected flow time (FTc) by oesophageal Doppler is considered to be a 'static' preload index. We evaluated the ability of FTc to predict fluid responsiveness and compared this with the abilities of other preload indices, such as pulse pressure variation (PPV), central venous pressure (CVP), and left ventricular end-diastolic area index (LVEDAI). Methods. Twenty neurosurgical patients were studied. After induction of anaesthesia, FTc, PPV, LVEDAI, CVP, and stroke volume index (SVI) were measured before and 12 min after fluid loading with 6% hydroxyethyl starch solution (7 ml kg-1). Responders and non-responders were defined as those patients with an SVI increase ≥10% or <10% after fluid loading, respectively. Pearson's correlation was used to assess correlations between changes in SVI and initial haemodynamic variables. Receiver operating characteristic (ROC) curves were constructed and compared to evaluate the overall performance of preload indices (FTc, PPV, LVEDAI, and CVP) in terms of predicting fluid responsiveness. Results. FTc and PPV before fluid loading differed between responders (n = 11) and non-responders (n = 9), and correlated with changes in SVI (r = -0.515 and r = 0.696, respectively), which was opposite to that observed for CVP or LVEDAI. Areas under ROC curves for FTc [0.944 (SD 0.058)] and PPV [0.909 (0.069)] were significantly greater than those for CVP [0.540 (0.133), P < 0.001] and LVEDAI [0.495 (0.133), P < 0.001]. The optimal threshold value given by ROC analysis was 357 ms for FTc. Conclusions. In this study, FTc predicted fluid responsiveness. However, FTc should be used in conjunction with other clinical information.

KW - Cardiac output

KW - Fluid balance

KW - Heart

KW - Monitoring, arterial pressure

KW - Monitoring, cardiopulmonary

KW - Monitoring, intraoperative

UR - http://www.scopus.com/inward/record.url?scp=34548247113&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=34548247113&partnerID=8YFLogxK

U2 - 10.1093/bja/aem179

DO - 10.1093/bja/aem179

M3 - Article

VL - 99

SP - 343

EP - 348

JO - British Journal of Anaesthesia

JF - British Journal of Anaesthesia

SN - 0007-0912

IS - 3

ER -