ABSTRACT

For mechanically ventilated patients, the best predictors of fluid responsiveness are dynamic parameters. Many methods that reflect cardiopulmonary interactions have been proposed to evaluate the preload dependency. In this study, we describe the interchangeability between respiratory variations of the subclavian (∆SCV) vein and pulse pressure variation (PPV) in sedated and mechanically ventilated patients benefiting from kidney transplantation.

The ∆SCV via infraclavicular transthoracic echocardiography and PPV measurements were recorded simultaneously by a single operator. The Bland–Altman method assessed the interchangeability between ∆SCV and PPV.

A total of 27 patients were prospectively included in the study. The Bland–Altman analysis showed a bias of +1.6 % for ∆SCV measurements vs. PPV. The limit of agreements was, respectively, −4% and 8%. The agreement between PPV >13% and ∆SCV >13% was 100%, and the agreement between PPV<9% and ∆SCV<9% was 58%. No misclassification (PPV<9% [0%] and PPV>13% [0%]) was observed.

ΔSCV and PPV are interchangeable when assessing preload dependency in mechanically ventilated patients benefiting from kidney transplantation. ΔSCV appears to be a suitable tool because it is non-invasive, simple, easy and almost always available.

Keywords: Echography, interchangeability, pulse pressure variation, subclavian vena