Dados do Trabalho

Título

Predictors of fluid responsiveness in the postoperative: A Prospective Study

Objetivo

This study aimed to evaluate hemodynamic parameters, both static and dynamic, for predicting fluid responsiveness in the postoperative period of cardiac surgery.

Métodos

A prospective study was conducted in the immediate postoperative period of myocardial revascularization surgery in adult patients. All patients were intubated and mechanically ventilated with a tidal volume of 6 mL/kg. Sedation was administered with 100 µg of fentanyl, and 10 mg of cisatracurium if needed. Exclusion criteria included severe cardiac and vascular conditions. Volume replacement was based on signs of tissue hypoperfusion, with four measurements taken: at baseline, after passive leg raising (PLR), upon return to baseline, and after volume infusion. A positive response was defined as ≥15% increase in cardiac index (CI).

Resultados

Seventy patients were included, with 50 (71.4%) classified as responders. No significant differences were found between groups in heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and central venous pressure (CVP). PLR-induced CI increase had 72% sensitivity and 50% specificity, while stroke volume variation (SVV) had 57.9% sensitivity and 58% specificity.

Conclusão

Static variables (HR, MAP, and CVP) did not correlate with CI increase after volume administration. Dynamic tests (PLR and SVV) showed low accuracy in predicting volume response in the postoperative period of cardiac surgery.