Volume responsiveness revisited: an observational multicenter study of continuous versus binary outcomes combining echocardiography and venous return physiology

Author:

Aneman Anders123ORCID,Schulz Luis12ORCID,Prat Gwenaël4,Slama Michel5,Vignon Philippe678,Vieillard-Baron Antoine91011

Affiliation:

1. Intensive Care Unit, Liverpool Hospital, South Western Sydney Local Health District, Sydney, New South Wales, Australia

2. Southwestern Clinical School, University of New South Wales, Sydney, New South Wales, Australia

3. Faculty of Health Sciences, Macquarie University, Sydney, New South Wales, Australia

4. Medical Intensive Care Unit, Brest University Hospital, Brest, France

5. Medical Intensive Care Unit, Amiens University Hospital, Amiens, France

6. Medical-Surgical Intensive Care Unit, Limoges University Hospital, Limoges, France

7. INSERM CIC 1435, Limoges University Hospital, Limoges, France

8. Faculty of Medicine, University of Limoges, Limoges, France

9. Intensive Care Unit, Assistance Publique-Hôpitaux de Paris, University Hospital Ambroise Paré, Boulogne-Billancourt, France

10. INSERM U-1018, CESP, Team 5, University of Versailles Saint-Quentin en Yvelines, Villejuif, France

11. Faculty of Medicine Paris Ile-de-France Quest, University of Versailles Saint-Quentin en Yvelines, Villejuif, France

Abstract

The analog mean systemic filling pressure and the pressure gradient for venous return combined with echocardiography predict continuous changes in stroke volume following a passive leg raising maneuver. The confounding effects of impaired right ventricular function and increased intra-abdominal pressure can be identified. Using a binary cutoff for the fractional change in stroke volume, common in previous clinical research, fails to identify the importance of variables relevant to venous return physiology and confounding conditions.

Publisher

American Physiological Society

Subject

Physiology (medical),Cardiology and Cardiovascular Medicine,Physiology

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