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Letter to the Editor
Cardiology Research and Practice
Volume 2012, Article ID 191807, 8 pages
http://dx.doi.org/10.1155/2012/191807
Clinical Study

Hemodynamic Changes during a Deep Inspiration Maneuver Predict Fluid Responsiveness in Spontaneously Breathing Patients

1Service de Réanimation Polyvalente, Centre Hospitalier Jean Bernard, Avenue Désandrouin, 59300 Valenciennes, France
2Service de Réanimation Médicale et Médecine Hyperbare, Hopital Albert Calmette, CHRU de Lille, Boulevard du Professeur J. Leclercq, 59037 Lille Cedex, France
3Université Lille Nord de France, EA 3614, 59000 Lille, France

Received 24 May 2011; Accepted 20 September 2011

Academic Editor: Philippe Vignon

Copyright © 2012 Sébastien Préau et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Objective. We hypothesized that the hemodynamic response to a deep inspiration maneuver (DIM) indicates fluid responsiveness in spontaneously breathing (SB) patients. Design. Prospective study. Setting. ICU of a general hospital. Patients. Consecutive nonintubated patients without mechanical ventilation, considered for volume expansion (VE). Intervention. We assessed hemodynamic status at baseline and after VE. Measurements and Main Results. We measured radial pulse pressure (PP) using an arterial catheter and peak velocity of femoral artery flow (VF) using continuous Doppler. Changes in PP and VF induced by a DIM ( PPdim and VFdim) were calculated in 23 patients. PPdim and VFdim ≥12% predicted responders to VE with sensitivity of 90% and specificity of 100%. Conclusions. In a restricted population of SB patients with severe sepsis or acute pancreatitis, PPdim and VFdim are accurate indices for predicting fluid responsiveness. These results should be confirmed in a larger population before validating their use in current practice.