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Paromov K.V.

Volosevich Arkhangelsk City First Clinical Hospital

Volkov D.A.

Volosevich Arkhangelsk City First Clinical Hospital;
Northern State Medical University

Kirov M.Yu.

Volosevich Arkhangelsk City First Clinical Hospital;
Northern State Medical University

Hemodynamic parameters of venous return and their role in assessment of fluid responsiveness in cardiac surgery

Authors:

Paromov K.V., Volkov D.A., Kirov M.Yu.

More about the authors

Journal: Russian Journal of Anesthesiology and Reanimatology. 2025;(2): 6‑12

DOI: 10.17116/anaesthesiology20250216

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Table of contents

HEMODYNAMIC PARAMETERS OF VENOUS RETURN AND THEIR ROLE IN ASSESSMENT OF FLUID RESPONSIVENESS IN CARDIAC SURGERY
HEMODYNAMIC PARAMETERS OF VENOUS RETURN AND THEIR ROLE IN ASSESSMENT OF FLUID RESPONSIVENESS IN CARDIAC SURGERY

To cite this article:

Paromov KV, Volkov DA, Kirov MYu. Hemodynamic parameters of venous return and their role in assessment of fluid responsiveness in cardiac surgery. Russian Journal of Anesthesiology and Reanimatology. 2025;(2):6‑12. (In Russ.)
https://doi.org/10.17116/anaesthesiology20250216

МСФ на ЯМ
Использование инфографики авторами научных работ
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Abstract:

OBJECTIVE

To evaluate diagnostic value of mean systemic filling pressure (Pmsa) and its derivatives, including cardiac power (CPvol), the driving pressure of venous return (Pmsa–central venous pressure), cardiac efficiency (Eh) and volemic efficiency (Evol) determined by passive leg raise (PLR test) and infusion bolus (IB) tests, in predicting fluid responsiveness after off-pump coronary artery bypass grafting (CABG) under sevoflurane anesthesia.

MATERIAL AND METHODS

Post hoc analysis included 49 patients after off-pump CABG, who sequentially underwent PLR test and IB test within an hour after surgery. In responders, cardiac index measured by thermodilution increased by ≥15% after reference test with IB and by ≥10% after PLR test.

RESULTS

Responders to IB test comprised 55.1%, to PLR test — 75.5% (k=0.31; 95% CI 0.06—0.56). No difference in Pmsa and central venous pressure was revealed. Central venous pressure increment was higher in responders when using both tests (p<0.05). Dynamics of CPvol were similar in both groups. Eh increased from 0.32±0.05 to 0.35±0.07 (p=0.002) in PLR test and to 0.39±0.12 in IB test (p<0.001). AUROC for Evol in PLR test was 0.517 (95% CI 0.349—0.684), in IB test — 0.493 (95% CI 0.326—0.661).

CONCLUSION

Dynamics of mean systemic filling pressure and its derivatives in assessing early postoperative fluid responsiveness after off-pump CABG is nonspecific. Monitoring of these parameters does not improve consistency of PLR and IB tests.

Keywords:

venous return
hemodynamics
monitoring
coronary artery bypass grafting

Authors:

Paromov K.V.

Volosevich Arkhangelsk City First Clinical Hospital

Volkov D.A.

Volosevich Arkhangelsk City First Clinical Hospital;
Northern State Medical University

Kirov M.Yu.

Volosevich Arkhangelsk City First Clinical Hospital;
Northern State Medical University

Received:

25.09.2024

Accepted:

13.10.2024

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References:

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