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Can stroke volume variation be an alternative to central venous pressure in patients undergoing kidney transplantation?
Chin, J-H; Jun, I-G; Lee, J; Seo, H; Hwang, G-S; Kim, Y-K.
Afiliación
  • Chin JH; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Jun IG; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Lee J; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Seo H; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Hwang GS; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea.
  • Kim YK; Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, South Korea. Electronic address: kyk@amc.seoul.kr.
Transplant Proc ; 46(10): 3363-6, 2014 Dec.
Article en En | MEDLINE | ID: mdl-25498052
BACKGROUND: Stroke volume variation (SVV) is known to be a simple and less invasive hemodynamic parameter for evaluating fluid responsiveness and preload status. Central venous pressure (CVP) has been targeted to achieve an adequate level for improving the graft perfusion and long-term graft function in kidney transplantation (KT) recipients, despite the various potential complications. The aim of this study was to investigate whether SVV could substitute for CVP in guiding intravascular volume management during KT. METHODS: This retrospective study evaluated 635 patients who underwent KT because of end-stage renal disease. Hemodynamic variables including CVP and SVV were obtained before skin incision (T1), 5 minutes after iliac vein clamping (T2), and 10 minutes after renal graft reperfusion (T3). The ability of SVV to predict CVP level was investigated with receiver operating characteristic (ROC) curve analysis. RESULTS: CVPs were 6.0 ± 2.6, 8.6 ± 2.7, and 9.3 ± 2.5 mm Hg, and SVVs were 6.9 ± 3.0, 5.0 ± 2.1, and 4.3 ± 2.1% at T1, T2, and T3, respectively. ROC analysis showed that the discriminative power of SVV was fairly good with an area under the ROC curve of 0.70 (95% confidence interval, 0.67-0.72) for a CVP of 8 mm Hg, and that an optimal cutoff value of SVV was 6% as an alternative to CVP of 8 mm Hg during KT. CONCLUSIONS: SVV may replace CVP in the volume management of patients who have undergone KT. Our results suggest that SVV can guide volume management to improve graft perfusion at critical time points during KT.
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Volumen Sistólico / Presión Venosa Central / Trasplante de Riñón / Funcionamiento Retardado del Injerto / Fluidoterapia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Transplant Proc Año: 2014 Tipo del documento: Article País de afiliación: Corea del Sur Pais de publicación: Estados Unidos
Texto completo
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Texto completo: 1 Colección: 01-internacional Base de datos: MEDLINE Asunto principal: Volumen Sistólico / Presión Venosa Central / Trasplante de Riñón / Funcionamiento Retardado del Injerto / Fluidoterapia Tipo de estudio: Observational_studies / Prognostic_studies / Risk_factors_studies Límite: Adult / Aged / Female / Humans / Male / Middle aged Idioma: En Revista: Transplant Proc Año: 2014 Tipo del documento: Article País de afiliación: Corea del Sur Pais de publicación: Estados Unidos