2010 MSARF Symposium Participants - Foundation for Anesthesia ...

enable us to undertake future cost-effectiveness analyses of blood conservation strategies while estimating direct financial
impact of future blood management strategies. Future studies linking patient outcomes with the cost of transfusion, as well
as estimating the financial impact of morbidities attributable to transfusion will be critical in directing the future of blood
transfusion medicine and developing strategies to modify blood transfusion practices.
Student Name: Christopher Nguyen
Host Department: University of California Irvine
Primary Mentor Name: Maxime Cannesson, MD, PhD
Title of Research Project: The Ability of Stroke Volume Variations Obtained with the Endotracheal Cardiac
Output Monitor to Predict Fluid Responsiveness in Mechanically Ventilated Patients
Introduction: Dynamic parameters of fluid responsiveness, such as stroke volume variation (SVV), are far superior to
static indicators (such as central venous pressure). A new endotracheal cardiac output monitor (ECOM, Conmed
Corporation; Irvine, CA) allows for cardiac output monitoring using bio-impedance. The ECOM continuously calculates
and displays stroke volume variation (SVVECOM). The goal of this prospective study was to test the ability of
SVVECOM to predict fluid responsiveness in mechanically ventilated patients under general anesthesia.
Methods: We studied 10 patients undergoing cardiac surgery. Exclusion criteria included severe tricuspid regurgitation,
congestive heart failure (Ejection fraction < 25 %), and arrhythmia. All patients were equipped with an ECOM
endotracheal tube and a pulmonary artery catheter (PAC). For all patients, cardiac output (CO) was measured using
pulmonary artery thermodilution before and after 500 ml fluid infusion. SVV before and after fluid infusion were also
recorded via ECOM. Fluid responders were defined as an increase in CO > 12% after fluid bolus.
Results: Overall, 10 measurements were performed. There were 4 responders, 6 non-responders. There was a statically
significant correlation between SVV pre-fluid and change in CO after fluid infusion (r = 0.76). The SVV pre-fluid was
significantly greater in responders than non-responders (p