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Bedside Assessment of Preload in Acute Circulatory Failure Using Cardiac Velocimetry

Soliman R, Zeid D, Yehya M, Nahas R

Background: Stroke volume variation (SVV) assessment using electric cardiometry could offer an alternative to invasive maneuvers for determining fluid response.

Methods: Thirty patients with severe sepsis and hypotension (Mean arterial pressure i.e., MAP<65 mmHg), were enrolled in our study. Fluid resuscitation (30 ml/kg) was administered. Fluid response was defined as MAP ≥ 65 mmHg and lactate <4 mmol/L. Preload assessment was done through SVV, to assess fluid response.

Results: The study included 13 males (43.3%) with age 47.8 ± 19.7. Paired comparison showed significant change in MAP readings (P value <0.001). ROC curve showed cutoff 12.5% for delta CO to predict fluid responsiveness with Area under Curve (AUC) 0.927, sensitivity 90.0%, and specificity 70.0%. ROC also showed delta CO cutoff 12.5% to predict survival with AUC 0.756, sensitivity 66.7% and specificity 66.7%.

Conclusion: Stroke volume variation, measured by electric cardiometry could be used to predict fluid response and survival in acute circulatory failure in septic critically ill patients.