Different predictabilities of volumetric response by pulse pressure variation in children after surgical re-pair of ventricular septal defect or tetralogy of Fallot
10.3969/j.issn.1006-5725.2017.23.022
- VernacularTitle:脉压变异度在室间隔缺损和法洛四联症患儿预测容量反应的不同
- Author:
Gang CHEN
1
;
Ding HAN
;
Jia LI
;
dong Shou PAN
;
Chuan OUYANG
Author Information
1. 首都儿科研究所附属儿童医院麻醉科
- Keywords:
congenital heart disease;
cardiac surgery;
pulse pressure variation;
volumetric response
- From:
The Journal of Practical Medicine
2017;33(23):3937-3941
- CountryChina
- Language:Chinese
-
Abstract:
Objective To compare the difference in pulse pressure variation(PPV)to predict volumetric response in children with ventricular septal defect(VSD)and tetralogy of Fallot(TOF). Methods VSD group consisted of 38 patients,aged 1.05 ± 0.75 years,while TOF group consisted of 36 patients,aged 1.15 ± 0.68 years. After separation from cardiopulmonary bypass,fluid infusion therapy was administered. PPV was recorded using pressure recording analytical method along with cardiac index(CI)before and after fluid infusion. Patients were considered as responders to fluid loading when CI increased ≥15%.Receiver operating characteristic(ROC) analysis was used to assess the accuracy and cutoffs of PPV to predict volumetric response.Results The PPV val-ues before and after fluid infusion were significantly lower in TOF group than that in VSD group(P < 0.01 for both).In VSD group,27 were responders and 11 nonresponders.ROC curve area was 0.89 and cutoff value 17.4%. In TOF group,26 were responders and 10 nonresponders.ROC curve area was 0.79 and cutoff value 13.4%.Con-clusion PPV is predictive of volumetric response in VSD and TOF patients following cardiac surgery.PPV's pre-dictivity and cutoff value are higher than the former. PPV is affected by right ventricle-pulmonary artery circula-tion,under-fluid infusion should be avoided in TOF due to lower PPV,over-fluid infusion should be avoided in VSD due to higher PPV.
