Kim Y K, Shin W J, Song J G, Jun I G, Kim H Y, Seong S H, Hwang G S
Asan Medical Center, University of Ulsan College of Medicine, 388-1 Pungnap 2dong, Song pa-gu, Seoul 138-736, South Korea.
Transplant Proc. 2009 Dec;41(10):4220-8. doi: 10.1016/j.transproceed.2009.09.050.
Stroke volume variation (SVV) is being increasingly used to predict fluid responsiveness. Since radial arterial pressure (RAP) and femoral arterial pressure (FAP) frequently showing discrepancies during liver transplantation (LT), we sought to investigate the effect of differing arterial waveforms on SVV and cardiac output (CO) derived from the Vigileo device, by comparing SVV and CO values derived from RAP (SVV(RAP), CO(RAP)) and FAP (SVV(FAP), CO(FAP)) during LT.
The linear associations and agreements between SVV(RAP) and SVV(FAP) and between CO(RAP) and CO(FAP) were assessed during LT. Hemodynamic variables were measured at nine predefined time points in all 32 recipients, resulting in 288 data pairs.
Correlations were observed between SVV(RAP) and SVV(FAP) (r = .961) and between CO(RAP) and CO(FAP) (r = .848) at all time points. These correlations between SVV(RAP) and SVV(FAP) (r = .923) and between CO(RAP) and CO(FAP) (r = .902) existed even during the period when mean RAP and FAP values differed (10 minutes after reperfusion). Bland-Altman analysis for SVV(RAP) versus SVV(FAP) and for CO(RAP) versus CO(FAP) showed weak biases (-0.2% and -0.5 L/min) and reasonable limits of agreement (-2.2 to 1.8% and -1.9 to 0.9 L/min). The percentage errors for SVV and CO values were 27.0% and 22.2%.
There was no significant difference between SVV(RAP) and SVV(FAP) when measured using the Vigileo device during LT. This finding indicated that SVV obtained using the Vigileo device offered relatively consistent information regardless of the catheterization site.
每搏量变异（SVV）越来越多地用于预测液体反应性。由于在肝移植（LT）期间桡动脉压（RAP）和股动脉压（FAP）经常出现差异，我们试图通过比较肝移植期间从RAP（SVV（RAP），CO（RAP））和FAP（SVV（FAP），CO（FAP））得出的SVV和心输出量（CO），来研究不同动脉波形对Vigileo设备得出的SVV和CO的影响。
在肝移植期间评估SVV（RAP）与SVV（FAP）之间以及CO（RAP）与CO（FAP）之间的线性关联和一致性。在所有32例接受者的九个预定义时间点测量血流动力学变量，产生288个数据对。
在所有时间点，SVV（RAP）与SVV（FAP）之间（r = 0.961）以及CO（RAP）与CO（FAP）之间（r = 0.848）均观察到相关性。即使在平均RAP和FAP值不同的时期（再灌注后10分钟），SVV（RAP）与SVV（FAP）之间（r = 0.923）以及CO（RAP）与CO（FAP）之间（r = 0.902）也存在这些相关性。对SVV（RAP）与SVV（FAP）以及CO（RAP）与CO（FAP）进行的Bland-Altman分析显示偏差较小（-0.2％和-0.5 L/min），一致性界限合理（-2.2至1.8％和-1.9至0.9 L/min）。SVV和CO值的百分比误差分别为27.0％和22.2％。
在肝移植期间使用Vigileo设备测量时，SVV（RAP）与SVV（FAP）之间无显著差异。这一发现表明，无论导管插入部位如何，使用Vigileo设备获得的SVV提供的信息相对一致。
