International Journal of Medical Sciences

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19 October 2017

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Int J Med Sci 2013; 10(6):751-757. doi:10.7150/ijms.6074

Research Paper

Is Stroke Volume Variation a Useful Preload Index in Liver Transplant Recipients? A Retrospective Analysis

Sung-Hoon Kim1, Gyu-Sam Hwang1, Seon-Ok Kim2, Young-Kug Kim1 ✉

1. Department of Anesthesiology and Pain Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea;
2. Department of Clinical Epidemiology and Biostatistics, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.

Abstract

Background: The right ventricular end-diastolic volume index (RVEDVI) is a good indicator of preload in patients undergoing liver transplantation. Although dynamic indices, such as stroke volume variation (SVV), have been used as reliable indicators in predicting fluid responsiveness, the evaluation of the relationship between SVV and direct preload status is limited. We investigated the relationship between SVV and RVEDVI, and tested the cutoff value of SVV to predict RVEDVI during liver transplantation.

Methods: A total of 150 data pairs in 30 living donor liver transplant recipients were retrospectively investigated. Hemodynamic parameters, including SVV and RVEDVI were obtained from each patient at the 5 specific time points. Linear regression and receiver operating characteristic (ROC) curve analyses were performed.

Results: The SVV significantly correlated with the RVEDVI (r = -0.616, P < 0.001). Cutoff values for the upper and lower tertiles of RVEDVI were 157 mL/m2 and 128 mL/m2, respectively. Tertile analysis indicated that upper tertile of RVEDVI had a significantly lower SVV than the middle tertile (median; 5% vs 8%, P < 0.05), and middle tertile of RVEDVI had a significantly lower SVV than the lower tertile (median; 8% vs 11%, P < 0.05). A 6% cutoff value of SVV estimated the upper tertile RVEDVI (>157 mL/m2) with the area under the curve of ROC curve of 0.832. A 9% cutoff value of SVV estimated the lower tertile RVEDVI (<128 mL/m2) with the area under the curve of ROC curve of 0.792.

Conclusion: SVV may be a valuable estimator of RVEDVI in patients undergoing liver transplantation.

Keywords: liver transplantation, preload index, stroke volume variation, right ventricular end-diastolic volume index.

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How to cite this article:
Kim SH, Hwang GS, Kim SO, Kim YK. Is Stroke Volume Variation a Useful Preload Index in Liver Transplant Recipients? A Retrospective Analysis. Int J Med Sci 2013; 10(6):751-757. doi:10.7150/ijms.6074. Available from http://www.medsci.org/v10p0751.htm