Accuracy of ΔVpeak and ΔVTI of left ventricular outflow tract in predicting fluid responsiveness in elderly patients with acute circulatory failure after surgery for gastrointestinal neoplasms
10.3760/cma.j.cn131073.20230816.00415
- VernacularTitle:左室流出道ΔVpeak和ΔVTI对胃肠肿瘤术后急性循环衰竭老年患者容量反应性的预测效果
- Author:
Jingjie WAN
1
;
Li XU
;
Jin XIE
Author Information
1. 苏州大学附属第一医院麻醉手术科，苏州 215000
- Keywords:
Vascular capacitance;
Echocardiography, Dopple;
Aged;
Gastrointestinal neoplasms
- From:
Chinese Journal of Anesthesiology
2024;44(4):457-460
- CountryChina
- Language:Chinese
-
Abstract:
Objective:To evaluate the accuracy of the respiratory variability of peak velocity (ΔVpeak) and velocity-time integral (ΔVTI) of left ventricular outflow tract in predicting fluid responsiveness in elderly patients with acute circulatory failure after surgery for gastrointestinal neoplasms.Methods:Seventy-six elderly patients of either gender, aged 65-90 yr, with acute circulatory failure admitted to the intensive care unit after elective surgery for gastrointestinal neoplasms in our hospital from June 2022 to July 2023, were selected. Pulse pressure variation (PPV) was measured before passive leg raising test. The ΔVpeak, ΔVTI and stroke volume (SV) were measured by echocardiography. The fluid responsiveness was defined as an increase in SV (ΔSV) > 10% after passive leg raising test, and the patients were divided into 2 groups: responsiveness group and non-responsiveness group. The correlations between PPV, ΔVpeak, ΔVTI and ΔSV were evaluated by Pearson′s correlation. The receiver operating characteristic curve was plotted, and the area under the receiver operating characteristic curve (AUC) was calculated, and the accuracy of PPV, ΔVpeak and ΔVTI in predicting fluid responsiveness was assessed.Results:There were 36 cases in responsiveness group and 40 cases in non-responsiveness group. The PPV, ΔVpeak, and ΔVTI were significantly higher in responsiveness group than in non-responsiveness group ( P<0.05). PPV, ΔVpeak and ΔVTI were positively correlated with ΔSV ( rPPV=0.485, 95% confidence interval [ CI] 0.291-0.640; rΔVpeak=0.734, 95% CI 0.610-0.823; rΔVTI=0.754, 95% CI 0.636-0.837; P<0.001). The AUC of PPV in predicting fluid responsiveness was 0.686, the cut-off value was 8%, the sensitivity was 80.6%, and the specificity was 47.5%. The AUC of ΔVpeak in predicting fluid responsiveness was 0.868, the cut-off value was 12.2%, the sensitivity was 69.4%, and the specificity was 90.0%. The AUC of ΔVTI in predicting fluid responsiveness was 0.885, the cut-off value was 12.7%, the sensitivity was 77.8%, and the specificity was 87.5%. Conclusions:The ΔVpeak and ΔVTI of left ventricular outflow tract can accurately predict the fluid responsiveness in elderly patients with acute circulatory failure after surgery for gastrointestinal neoplasms.
