Respiratory failure & ventilation
The Accuracy of Velocity-Time Integral Variation and Peak Velocity Variation of the Left Ventricular Outflow Tract in Predicting Fluid Responsiveness in Postoperative Patients Mechanically Ventilated at Low Tidal Volumes
Authors' conclusion
In postoperative critically ill patients mechanically ventilated with tidal volume <8 mL/kg, the VTI variation and Vpeak variation of LVOT accurately could predict fluid responsiveness, and VTI variation showed more accuracy than Vpeak variation in predicting fluid responsiveness.
Study context
- Population
- Postoperative critically ill patients with deep sedation and mechanical ventilation (tidal volume <8 mL/kg), surgical ICU of a tertiary hospital32 (53.3%) fluid responders
- Participants
- 60 patients
- Comparison
- Left ventricular outflow tract (LVOT) velocity-time integral (VTI) variation and Vpeak variation vs PPV for predicting fluid responsiveness after passive leg raising
- Outcome
- Prediction of fluid responsiveness
Methodological detailsprospective, single-centre, observational
- Prospective
- Single-centre
- Observational
Performance
As reported in the abstract
| Test or model | AUC | Best cutoff | Sensitivity | Specificity | Gray zone | Patients in gray zone |
|---|---|---|---|---|---|---|
| VTI variation | 0.919 | 12.51% | 71.9% | 75.0% | 7.41% to 11.88% | 23.3% |
| Vpeak variation | 0.905 | 11.76% | 81.3% | 89.3% | 9.96% to 13.10% | 28.3% |
| PPV | 0.797 | 58.3% |
AUC
VTI variation0.919
Vpeak variation0.905
PPV0.797
Best cutoff
VTI variation12.51%
Vpeak variation11.76%
PPV— not stated in the abstract
Sensitivity
VTI variation71.9%
Vpeak variation81.3%
PPV— not stated in the abstract
Specificity
VTI variation75.0%
Vpeak variation89.3%
PPV— not stated in the abstract
Gray zone
VTI variation7.41% to 11.88%
Vpeak variation9.96% to 13.10%
PPV— not stated in the abstract
Patients in gray zone
VTI variation23.3%
Vpeak variation28.3%
PPV58.3%
Parts of this Brief are withheld: the automatic checks could not confirm them against the abstract.
Original publication
The Accuracy of Velocity-Time Integral Variation and Peak Velocity Variation of the Left Ventricular Outflow Tract in Predicting Fluid Responsiveness in Postoperative Patients Mechanically Ventilated at Low Tidal Volumes. J Cardiothorac Vasc Anesth. Published 9 February 2023. doi:10.
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