Purpose: The evaluation of a mini or simulated fluid challenge is still a complex and open issue in the clinical setting and it is of paramount significance for the fluid therapy optimization. We here investigated the capacity of a new hemodynamic parameter, the venous Pulse Wave Velocity (vPWV), to detect the effect of passive leg raising (PLR). Materials and methods: In 15 healthy volunteers (7 M, 8 F, age 26 ± 3) venous pressure pulses were elicited by pneumatic compressions of the left hand and proximally detected by ultrasound for calculation of the vPWV. We also non-invasively measured the basilic vein (BV) cross-sectional perimeter, and peripheral venous pressure (PVP). The PLR manoeuvre was performed twice to evaluate reliability of the assessment. Results: The PLR had an overall statistically significant effect on the entire set of variables (MANOVA, p < 0.05): vPWV increased from 2.11 ± 0.46 to 2.30 ± 0.47 m/s (p = 0.01; average increase: 10%). This effect was transient and dropped below 5% after about 3 min. A significant increase was also exhibited by BV size and PVP. In consecutive measurements vPWV showed little intra-subject variability (CoV = 8%) and good reliability (ICC = 0.87). Finally, the vPWV responses to the two PLRs exhibited good agreement (paired T-test: p = 0.96), and moderate reliability (ICC = 0.57). Conclusion: These results demonstrated that vPWV can be non-invasively, objectively and reliably measured in healthy subjects and that it is adequate to detect small pressure/volume variations, as induced by PLR-from-supine. These characteristics make it suitable for clinical applications.

Venous Pulse Wave Velocity variation in response to a simulated fluid challenge in healthy subjects

Ermini L.
First
;
Roatta S.
Last
2021-01-01

Abstract

Purpose: The evaluation of a mini or simulated fluid challenge is still a complex and open issue in the clinical setting and it is of paramount significance for the fluid therapy optimization. We here investigated the capacity of a new hemodynamic parameter, the venous Pulse Wave Velocity (vPWV), to detect the effect of passive leg raising (PLR). Materials and methods: In 15 healthy volunteers (7 M, 8 F, age 26 ± 3) venous pressure pulses were elicited by pneumatic compressions of the left hand and proximally detected by ultrasound for calculation of the vPWV. We also non-invasively measured the basilic vein (BV) cross-sectional perimeter, and peripheral venous pressure (PVP). The PLR manoeuvre was performed twice to evaluate reliability of the assessment. Results: The PLR had an overall statistically significant effect on the entire set of variables (MANOVA, p < 0.05): vPWV increased from 2.11 ± 0.46 to 2.30 ± 0.47 m/s (p = 0.01; average increase: 10%). This effect was transient and dropped below 5% after about 3 min. A significant increase was also exhibited by BV size and PVP. In consecutive measurements vPWV showed little intra-subject variability (CoV = 8%) and good reliability (ICC = 0.87). Finally, the vPWV responses to the two PLRs exhibited good agreement (paired T-test: p = 0.96), and moderate reliability (ICC = 0.57). Conclusion: These results demonstrated that vPWV can be non-invasively, objectively and reliably measured in healthy subjects and that it is adequate to detect small pressure/volume variations, as induced by PLR-from-supine. These characteristics make it suitable for clinical applications.
63:102177
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6
Passive leg raising; Venous return; Vessel stiffness; Volume status
Ermini L.; Chiarello N.E.; De Benedictis C.; Ferraresi C.; Roatta S.
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/2318/1768743
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