Dynamic Transesophageal Echocardiographic Parameters for Predicting Fluid Responsiveness in Mechanically Ventilated Patients

Abstract Background: The aim was to investigate the feasibility of the dynamic transesophageal echocardiographic parameters to predict fluid responsiveness in mechanically ventilated patients. Methods: In the prospective study, a total of 60 patients scheduled for elective general surgery under mechanical ventilation were enrolled. All patients received 10ml/kg Ringer’s lactate. The data including central venous pressure (CVP), cardiac index (CI), stroke volume variation (SVV), SVC-CI, E velocity, and the ratio of E/e’ was recorded before and after fluid challenge. Patients were classified as Responders (FR group) if their CI increased by at least 15% after fluid challenge. Results: 25/52(48%) were Responders and 27 were non-Responders (52%). The SVC-CI was higher in the Responders (41.90±11.48% vs 28.92±9.05%, P＜0.01). SVC-CI was significantly correlated with △CI (r=0.568, P＜0.01). The area under the ROC curve (AUROC) of SVC-CI was 0.838 (95% CI: 0.728～0.947, P＜0.01) with the optimal cut-off value of 39.4% (sensitivity 64%, specificity 92.6%). The best cut-off value for SVV was 12.5% (sensitivity 40%, specificity 89%) with the AUROC of 0.68 (95% CI 0.53～0.826, P＜0.05). Conclusion: The SVC-CI and SVV can predict fluid responsiveness effectively in mechanically ventilated patients. And SVC-CI is superior in predicting fluid responsiveness compared with SVV. Trial registration: Chinese Clinical Trial Registry, ChiCTR2000034940, Registered 25 July 2020, https://www.chictr.org.cn/index.aspx