Comparative study of pressure- and volume-controlled ventilation on stroke volume variation as a predictor of fluid responsiveness in patients undergoing major abdominal surgery

J Crit Care. 2012 Oct;27(5):531.e9-14. doi: 10.1016/j.jcrc.2011.11.012. Epub 2012 Feb 1.

Abstract

Purpose: We hypothesized that the 2 ventilation modes might have a different influence on the stroke volume variation (SVV). This study investigated the effect of the ventilation modes on SVV as a predictor of fluid responsiveness during major abdominal surgery.

Materials and methods: Sixty patients were randomly allocated to volume-controlled ventilation (VCV, n = 30) or pressure-controlled ventilation (PCV, n = 30) modes. After the induction of anesthesia, hemodynamic variables and SVV were measured before and after volume expansion (VE) with colloid solution of 10 mL/kg. The ability of SVV to predict the fluid responsiveness was tested by calculation of the area under a receiver operating characteristic curve for an increase in stroke volume index of at least 15% after VE.

Results: There were 10 and 16 responders in the VCV and PCV groups, respectively. The area under a receiver operating characteristic curve (95% confidence interval) for SVV before VE was 0.723 (0.538-0.907) and 0.799 (0.625-0.973) in the VCV and PCV groups, respectively. The optimal threshold value of SVV was 11% and 14% in the VCV and PCV groups, respectively.

Conclusions: Stroke volume variation can predict fluid responsiveness during both VCV and PCV modes. However, the optimal threshold values of SVV may differ according to the ventilation modes.

Publication types

  • Comparative Study
  • Randomized Controlled Trial

MeSH terms

  • Abdomen / surgery*
  • Aged
  • Colloids / therapeutic use
  • Female
  • Fluid Therapy*
  • Hemodynamics
  • Humans
  • Male
  • Middle Aged
  • Prospective Studies
  • ROC Curve
  • Respiration, Artificial / methods*
  • Stroke Volume / physiology*

Substances

  • Colloids