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:: Volume 4, Issue 4 (3-2016) ::
پرستاری قلب و عروق 2016, 4(4): 14-21 Back to browse issues page
Comparative study of pulse pressure variation and central venous pressure in evaluation of fluid status in mechanically ventilated patients after cardiac surgery
Mostafa Alavi1 , Tooraj Babaee1 , Mahshid Ghadrdoost2 , Alireza Azad * 3
1- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran
2- Iran University of Medical Sciences, Tehran, Iran
3- Rajaie Cardiovascular Medical and Research Center, Iran University of Medical Sciences, Tehran, Iran (*Corresponding Author) , Azad6588@gmail.com
Abstract:   (7878 Views)

Abstract

Aim.This study aimed to compare pulse pressure variation (PPV) with central venous pressure (CVP) in checking out and optimizing fluid volume in mechanically ventilated patients admitted to intensive care unit after cardiac surgery.

Background.In clinical area, assessment of body fluid and determination of the intravascular volume  after major surgeries such as heart surgery is a significant challenge. The initial purpose of intravascular volume assessment in patients with hemodynamic instability is to determine whether they would benefit from fluid administration or not.

Method. In the present study a prospective descriptive-analytic design was used. Thirty mechanically ventilated patients admitted to intensive care units of Rajaee Heart Center, Tehran, Iran, were recruited in the study after cardiac surgery based on inclusion criteria. Data collection tools included demographic and clinical data sheets. Hemodynamic parameters such as CVP, systolic and diastolic pressures (for calculating pulse pressure and its variation) were recorded by bedside monitoring. Cardiac Index (CI) was measured by non invasive continuous cardiac output monitoring (NICCOMO) system. Data were analyzed in SPSS version 20, using statistical tests.

Findings. The mean changes of CVP, before and five minutes after fluid administration, were significantly different (10.10±6.01 mmHg and 12.37±6.34 mmHg, respectively, p=0.015). The mean changes in arterial pulse pressure, before and five minutes after fluid administration, were significantly different (16.94±8.32 mmHg and 12.77±4.02 mmHg, respectively, P=0.005). At the cut point 2.8 lit/min/m2 for CI, the sensitivity and specificity values for PPV>13%, were 0.71 and 0.61, respectively. Also, at the same cut point, the sensitivity and specificity values for CVP<5mmHg, were 0.11 and 0.84, respectively. These findings suggest a higher diagnostic power  of  PPV compared to CVP to assess fluid volume.

Conclusion.It seems that in the mechanically ventilated patients after heart surgery, PPV dynamic index is preferred to CVP static index to evaluate and maintain fluid volume.

Keywords: Arterial pulse pressure, Central venous pressure, Intravascular volume, Mechanical ventilation, Intensive care unit, Cardiac surgery
Full-Text [PDF 900 kb]   (12721 Downloads)    
: Research | Subject: Hemodynamic monitoring
Received: 2015/11/06 | Accepted: 2016/05/11 | Published: 2016/08/07 | ePublished: 2016/08/07
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Alavi M, Babaee T, Ghadrdoost M, azad A. Comparative study of pulse pressure variation and central venous pressure in evaluation of fluid status in mechanically ventilated patients after cardiac surgery. پرستاری قلب و عروق 2016; 4 (4) :14-21
URL: http://journal.icns.org.ir/article-1-288-en.html


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Volume 4, Issue 4 (3-2016) Back to browse issues page
فصلنامه پرستاری قلب و عروق Iranian Journal of Cardiovascular Nursing
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