Skip to main content

Advertisement

Volume 3 Supplement 1

ESICM LIVES 2015

A comparison of global end-diastolic volume (GEDI) and central venous pressure (CVP) as parameter for volumen assessment in patients during major liver resections

Article metrics

  • 354 Accesses

Goal of Study

The aim of our study was to evaluate the predictive value of CVP with regard GEDI, and correlate these parameters to cardiac Index (CI) and extravascular lung water index (EVLWI).

Methods

Prospective study. Surgical intensive care unit, university hospital.

Patients and interventions: 89 hemodynamic measurements using the PiCCO (Pulsion Medical System, Germany) were performed in 18 patients during major liver resection

Results

Mean CVP (8,23 +/- 3,12 mmHg) was normal, whereas mean GEDI (615,2 +/- 135,44 mL/m2) was decreased. Thirty-one CVP measurements were elevated despite simultaneous GEDI levels indicating a normal or decreased preload. Sensitivity, specificity, positive predictive value, and negative predictive value of CVP with regard to volume depletion (GEDI < 650) were 6,28 (0-12,77. CI 95%), 100 (97,86-100, CI 95%, 43, 2 (28,99-50,82, CI 95%) respectively. CVP did not correlate to GEDI (r = -0,065, p = 0,32), CI (r = 0,23, p = 0,176) and EVLWI (extravascular lung water index) (r = -0,05, p= 0,49). GEDI significantly correlated to CI (r = -0,24, p < 0,01) and VVS (r = -0,39, p < 0,01).

Conclusions

Volume depletion according to GEDI was found in more than half the patients. The predictive values of CVP with regard to volume depletion were low GEDI and its changes significantly correlated to CI and its changes, which was not observed for CVP. Therefore, GEDI appears to be more appropriate for volume management during major liver resections with the aim to avoid intraoperative bleeding and transfusion.

Grant Acknowledgment

We express our gratitude to Mutua Madrileña Foundation (Madrid, Spain) for its grant collaboration by without which this work could not have been completed.

References

  1. 1.

    De la Rocca G, Costa MG, Coccia C, et al: Preload and hemodynamic assessment during liver transplantation. A comparison between pulmonary artery catheter and transpulmonar indicator dilution technique. Eur J Anesth. 2002, 19: 868-875. 10.1017/S0265021502001394.

  2. 2.

    Huber W, Umgelter A, Reindl W, et al: Volume assessment in patients with necrotizing pancreatitis: a comparison of intrathoracic blood volumen index, central venous pressure, and hematocrit, and their correlation to cardiac index and extravascular lung wáter. Crit Care Med. 2008, 36: 2348-5. 10.1097/CCM.0b013e3181809928.

Download references

Author information

Correspondence to FJ Redondo Calvo.

Rights and permissions

Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.org/licenses/by/4.0), which permits use, duplication, adaptation, distribution, and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made.

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Keywords

  • Public Health
  • Intensive Care Unit
  • Medical System
  • Cardiac Index
  • Central Venous Pressure