The correlation between the Trendelenburg position and the stroke volume variation.
10.4097/kjae.2014.67.6.378
- Author:
Jin Hye MIN
1
;
Sang Eun LEE
;
Hong Sik LEE
;
Young Keun CHAE
;
Yong Kyung LEE
;
Yoo KANG
;
Ui Jin JE
Author Information
1. Department of Anesthesiology and Pain Medicine, Myongji Hospital, Goyang, Korea. jhmin@kd.ac.kr
- Publication Type:Original Article
- Keywords:
Fluid therapy;
Reverse Trendelenburg position;
Stroke volume variation;
Trendelenburg position
- MeSH:
Anesthesia;
Blood Pressure;
Cardiac Output;
Fentanyl;
Fluid Therapy;
Head-Down Tilt*;
Heart Rate;
Humans;
Ideal Body Weight;
Operating Tables;
Posture;
Propofol;
Respiration, Artificial;
Respiratory Rate;
Stroke Volume*;
Ventilation
- From:Korean Journal of Anesthesiology
2014;67(6):378-383
- CountryRepublic of Korea
- Language:English
-
Abstract:
BACKGROUND: The stroke volume variation (SVV), based on lung-heart interaction during mechanical ventilation, is a useful dynamic parameter for fluid responsiveness. However, it is affected by many factors. The aim of this study was to evaluate the effects of SVV on Trendelenburg (T) and reverse Trendelenburg (RT) position and to further elaborate on the patterns of the SVV with position. METHODS: Forty-two patients undergoing elective surgery were enrolled in this study. Fifteen minutes after standardized induction of anesthesia with propofol, fentanyl, and rocuronium with volume controlled ventilation (tidal volume of 8 ml/kg of ideal body weight, inspiration : expiration ratio of 1 : 2, and respiratory rate of 10-13 breaths/min), the patients underwent posture changes as follows: supine, T position at slopes of operating table of -5degrees, -10degrees, and -15degrees, and RT position at slopes of operating table of 5degrees, 10degrees, and 15degrees. At each point, SVV, cardiac output (CO), peak airway pressure (PAP), mean blood pressure, and heart rate (HR) were recorded. RESULTS: The SVV was significant decreased with decreased slopes of operating table in T position, and increased with increased slopes of operating table in RT position (P = 0.000). Schematically, it was increased by 1% when the slope of operating table was increased by 5degrees. But, the CO and PAP were significant increased with decreased slopes of operating table in T position, and decreased with increased slopes of operating table in RT position (P = 0.045, 0.027). CONCLUSIONS: SVV is subjected to the posture, and we should take these findings into account on reading SVV for fluid therapy.
