| Title |
End-tidal carbon dioxide variation after a 100- and a 500-ml fluid challenge to assess fluid responsiveness
|
|---|---|
| Published in |
Annals of Intensive Care, April 2016
|
| DOI | 10.1186/s13613-016-0141-9 |
| Pubmed ID | |
| Authors |
Matthias Jacquet-Lagrèze, Florent Baudin, Jean Stéphane David, Jean-Luc Fellahi, Patrick B. Hu, Marc Lilot, Vincent Piriou |
| Abstract |
EtCO2 variation has been advocated replacing cardiac output measurements to evaluate fluid responsiveness (FR) during sepsis. The ability of EtCO2 variation after a fluid challenge to detect FR in the context of general anaesthesia has not been investigated. Forty patients were prospectively studied. They underwent general anaesthesia for major surgeries. CO was measured by transoesophageal Doppler, and EtCO2 was recorded as well as other haemodynamic parameters [heart rate (HR), mean arterial pressure (MAP), pulse pressure (PP)] at baseline, after 100-ml fluid load over 1 min, and at the end of the 500-ml fluid load. We measured the variation of EtCO2 at 100 (ΔEtCO2100) and 500 ml (ΔEtCO2500), and ROC curves were generated. A threshold for ΔEtCO2 to predict FR was determined with receiver operating curves (ROC) analysis. The primary end point was the ability of EtCO2 variation after a 500-ml fluid load to diagnose FR. Fifteen patients (38 %) were fluid responders. ROC analysis showed that for a threshold of 5.8 % (ΔEtCO2500), sensitivity was 0.6 IC 95 % [0.33; 0.86] and specificity was 1.0 IC 95 % [1.0; 1.0]. An absolute increase of more than 2 mmHg of EtCO2 is specific to diagnose fluid responsiveness (spe = 96 [88-100] %, sens = 60 [33-88] %, AUC = 0.80 [0.96-0.65]). HR, MAP, and PP variations and ΔEtCO2100 did not bring information to predict or diagnose FR. During fluid challenge, the correlation between CI variation and EtCO2 variation was r = 0.566, p < 0.001. During surgery, when alveolar ventilation and CO2 production are constant, ΔEtCO2500 is fairly reliable to assess FR. When the variation of EtCO2 is >5.8 %, all patients were responders, but no conclusion could be done when this variation was <5.8 %. ΔEtCO2100 failed to predict FR. Trial registration CPP Lyon Sud Est III ref: 2013-027 B, Number ID RCB: 2013-A00729-36 delivered by the ANSM). |
X Demographics
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Geographical breakdown
| Country | Count | As % |
|---|---|---|
| United Kingdom | 2 | 100% |
Demographic breakdown
| Type | Count | As % |
|---|---|---|
| Members of the public | 2 | 100% |
Mendeley readers
The data shown below were compiled from readership statistics for 51 Mendeley readers of this research output. Click here to see the associated Mendeley record.
Geographical breakdown
| Country | Count | As % |
|---|---|---|
| Unknown | 51 | 100% |
Demographic breakdown
| Readers by professional status | Count | As % |
|---|---|---|
| Other | 5 | 10% |
| Student > Postgraduate | 5 | 10% |
| Professor > Associate Professor | 5 | 10% |
| Student > Doctoral Student | 4 | 8% |
| Student > Ph. D. Student | 4 | 8% |
| Other | 12 | 24% |
| Unknown | 16 | 31% |
| Readers by discipline | Count | As % |
|---|---|---|
| Medicine and Dentistry | 29 | 57% |
| Computer Science | 3 | 6% |
| Nursing and Health Professions | 2 | 4% |
| Agricultural and Biological Sciences | 1 | 2% |
| Unknown | 16 | 31% |
Attention Score in Context
This research output has an Altmetric Attention Score of 2. This is our high-level measure of the quality and quantity of online attention that it has received. This Attention Score, as well as the ranking and number of research outputs shown below, was calculated when the research output was last mentioned on 25 April 2016.
All research outputs
#14,847,187
of 22,865,319 outputs
Outputs from Annals of Intensive Care
#786
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Outputs of similar age
#170,016
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Outputs of similar age from Annals of Intensive Care
#21
of 27 outputs
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