Anne Demarles SVV
|
Stroke Volume Variation “Can We Use Fluid to Improve
The figures to the right demonstrate using SVV as a guide for volume resuscitation with a goal SVV of |
| Anne Demarles SVV |
|
Meta-analysis of pulse pressure variation (PPV) and stroke
Meta-analysis of pulse pressure variation (PPV) and stroke volume variation (SVV) studies: a few rotten apples can spoil the whole barrel Author: Frederic Michard Subject: Critical Care https://doi org/10 1186/s13054-023-04765-3 Keywords: Anesthesia;Hemodynamic monitoring;Fluid responsiveness;Pulse pressure variation;Prediction Created Date |
What Is Stroke Volume Variation (Svv)?
Stroke volume variation is a measure of the change in stroke volume (SV) that occurs in respiration in patients. This change is induced by the heart lung interaction. It is measured from the stroke volume component of the arterial waveforms and calculated. More on the calculation shortly. eddyjoemd.com
Why Is Stroke Volume Variation Important?
SVV is a dynamic form of assessing for volume responsiveness in patients who are on mechanical ventilation and need resuscitation with IV fluids. It predicts the ability for there to be a change in the stroke volume with a fluid bolus. The major downside to this methodology is that you need some sort of device such as pulse contour analysis or bior
What Is The Stroke Volume Variation (SVV) equation?
SVV= (SVmax – SVmin) / SVmean SVV is calculated as the difference between the stroke volume on inspiration and expiration in the respiratory cycle. Fortunately, we don’t have to do it by hand these days. The machine/device does it for us and we get a pretty number. eddyjoemd.com
What Stroke Volume Variation (SVV) Is Considered “Normal”?
Depending on the literature, a patient who is predicted to be volume responsive will have an SVV>13% in most literature, but some will say >10%. In my practice, I use the former. The normal range of stroke volume variation is <13%. One could interpret the number that if it’s over 13%, they could potentially benefit from a fluid bolus. eddyjoemd.com
Does SVV Predict Fluid Responsiveness?
There was a meta-analysisthat looked at 568 patient in 23 different studies using a variety of different devices. The correlation coefficient to fluid responsiveness was 0.718 which means a “highly positive correlation”. The AUC of using SVV for fluid responsiveness is 0.84. 0.8-0.9 is considered “excellent”. It’s not all sunshine and roses, though
How Is SVV Measured?
There are various ways to assess the SVV: 1. Arterial waveform analysis 2. Pulse Contour Analysis 3. Esophageal doppler 4. Echocardiography (both TTE and TEE) I have personally only used pulse-contour analysis technologies to obtain this measurement. eddyjoemd.com
When Was SVV First Described in The Literature?
The first study to describe stroke volume variation (SVV) that I was able to find was back in in 2002. That article was titled “Stroke volume variations for assessment of cardiac responsiveness to volume loading in mechanically ventilated patients after cardiac surgery“. Here, they found that SVV was useful in cardiac surgery patients . It uses inc
Limitations of Stroke Volume Variation (SVV)
– needs to be on mechanical ventilation – no cardiac arrhythmias – tidal volume needs to be >8cc/kg of ideal body weight – you need a fancy machine – most devices need an arterial line Part of the issue is that clinicians are quick to forget these limitations. eddyjoemd.com
Stroke Volume Variation in Patients on Low Tidal Volumes
Stroke Volume Variation, also known as SVV, is a method to assess fluid responsiveness in critically ill patients. Criteria to obtain an accurate stroke volume variation include that the patient needs to be on the vent and not spontaneously breathing. They cannot have any cardiac arrhythmias. They need sometimes need arterial line and always need a
Does SVV Work on Patients Who Are Spontaneous Breathing?
Stroke Volume Variation doesn’t work in patients who are spontaneously breathing. I have seen clinicians who are well respected where they’ve said that it works “to trend” but I am not a fan of shortcuts. The AUC in those patients is 0.53 per the linked Zhang paper. Perner et al. found that this does not work with an AUROC of only 0.51. That means
|
2012 Numéro décision OPERATEUR Date de la déclaration Année
Date de la déclaration Année 2010 725 SVV CHAVILLE ENCHERES 07/01/ 2010 2010 726 V P O 01/01/ 2004 523 ANNE DEMARLES SVV 02/12/2004 |
![Program Book [PDF] - University Musical Society](https://p.calameoassets.com/201211152152-2048317fcd0a569ce778e379fe8cec98/p1.jpg "Program Book [PDF] - University Musical Society")
![Livre Gook Pratiques \](https://image.slidesharecdn.com/vthumanitiestimeandspace2-171119145242/95/time-space-annihilated-innovation-communication-and-society-64-638.jpg?cb\u003d1511103218 "Livre Gook Pratiques \")
