Right Ventricular End-Diastolic Volume in the Postoperative Care of Cardiac Surgery Patients : A Marker of the Hemodynamic Response to a Fluid Challenge
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概要
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Background This study evaluated the right ventricular end-diastolic volume index (RVEDVI) as a marker of the hemodynamic response to a fluid challenge in the postoperative care of cardiac surgery patients. Methods and Results Continuous RVEDVI and other hemodynamic parameters were analyzed during and after 17 fluid challenges with 480-500 ml colloids (5% albumin, fresh frozen plasma or 6% hydroxyethyl starch) given over 30-60 min following cardiac surgery. Changes in stroke volume index (SVI) were assessed to indicate fluid responsiveness. Responders were defined as those who experienced a 10% or greater increase in SVI. Fluid challenges with simultaneous changing of vasoactive agents were excluded. Linear regression analysis between the percentage change in SVI and baseline RVEDVI revealed a statistically significant but weak correlation (r^2=0.249; p=0.041). Although the baseline RVEDVI was higher in non-responders than in responders (112.4±6.1 vs 104.4±5.8ml/m^2; p=0.05), there was a marked overlap of baseline RVEDVI values, which did not allow identification of the threshold value of RVEDVI discriminating responders. Conclusions After cardiac surgery, RVEDVI reflected fluid responsiveness only to a limited degree. Patients should not be resuscitated to an absolute RVEDVI alone and empirical fluid challenge should still be required.
- 社団法人日本循環器学会の論文
- 2007-08-20
著者
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Ueda Yuichi
Department of Cardiothoracic Surgery, Nagoya University School of Medicine
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Ueda Yuichi
Graduate School Of Medicine Nagoya University
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Ueda Yuichi
名古屋大学 医学系研究科胸部外科学
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Song Min-ho
Department Of Cardiovascular Surgery Gifu Prefectural Tajimi Hospital
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USUI AKIHIKO
Department of Thoracic Surgery, Nagoya University School of Medicine
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Tokuda Yoshiyuki
Departments of Cardiovascular Surgery, Gifu Prefectural Tajimi Hospital
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Mabuchi Norifumi
Anesthesiology and Intensive Care Medicine, Gifu Prefectural Tajimi Hospital
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Song Min-ho
Department Of Cardiothoracic Surgery Nagoya University School Of Medicine
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Ueda Yuichi
Department Of Cardiac Surgery Nagoya University Graduate School Of Medicine
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Usui Akihiko
Graduate School Of Medicine Nagoya University
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Usui Akihiko
Department Of Cardiothoracic Surgery Nagoya University Graduate School Of Medicine
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Usui Akihiko
The Department Of Cardio-thoracic Surgery Nagoya University School Of Medicine
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Tokuda Yoshiyuki
Department Of Cardiovascular Surgery Gifu Prefectural Tajimi Hospital
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Mabuchi Norifumi
Anesthesiology And Intensive Care Medicine Gifu Prefectural Tajimi Hospital
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Tokuda Yoshiyuki
Department Of Cardiac Surgery Nagoya University Graduate School Of Medicine
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Ueda Yuichi
The Department Of Cardio-thoracic Surgery Nagoya University School Of Medicine
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Usui Akihiko
Department Of Cardiac Surgery Nagoya University Graduate School Of Medicine
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Song Min-Ho
Department of Cardiovascular Surgery, Gifu Prefectural Tajimi Hospital
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UEDA Yuichi
Department of Cardiac Surgery, Nagoya University Graduate School of Medicine
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