Assessment of stroke volume variation for prediction of fluid responsiveness using the modified FloTrac™ and PiCCOplus™ system

INTRODUCTION: Stroke volume variation (SVV) has repeatedly been shown to be a reliable predictor of fluid responsiveness. Various devices allow automated clinical assessment of SVV. The aim of the present study was to compare prediction of fluid responsiveness using SVV, as determined by the FloTrac™/Vigileo™ system and the PiCCOplus™ system. METHODS: In patients who had undergone elective cardiac surgery, SVV(FloTrac )was determined via radial FloTrac sensor, and SVV(PiCCO )and pulse pressure variation were assessed via a femoral PiCCO catheter. Stroke volume was assessed by transpulmonary thermodilution. All variables were recorded before and after a volume shift induced by a change in body positioning (from 30° head-up position to 30° head-down position). Pearson correlation, t-test, and Bland-Altman analysis were performed. Area under the curve was determined by plotting receiver operating characteristic curves for changes in stroke volume in excess of 25%. P < 0.05 was considered statistically significant. RESULTS: Body positioning resulted in a significant increase in stroke volume; SVV(FloTrac )and SVV(PiCCO )decreased significantly. Correlations of SVV(FloTrac )and SVV(PiCCO )with change in stroke volume were similar. There was no significant difference between the areas under the curve for SVV(FloTrac )and SVV(PiCCO); the optimal threshold values given by the receiver operating characteristic curves were 9.6% for SVV(FloTrac )(sensitivity 91% and specificity 83%) and 12.1% for SVV(PiCCO )(sensitivity 87% and specificity 76%). There was a clinically acceptable agreement and strong correlation between SVV(FloTrac )and SVV(PiCCO). CONCLUSION: SVVs assessed using the FloTrac™/Vigileo™ and the PiCCOplus™ systems exhibited similar performances in terms of predicting fluid responsiveness. In comparison with SVV(PiCCO), SVV(FloTrac )has a lower threshold value.