Predicting volume responsiveness by using the end -expiratory occlusion in mechanically ventilated patients with septic shock
Abstract：Objective To determine the reliability and feasibility of end-expiratory occlusion ( EEO) predicting fluid responsiveness in mechanically ventilated patients with septic shock.Methods Forty-one mechanically ventilated patients with septic shock, considered for volume expansion, were enrolled in the study.Cardiac index (CI), pulse pressure (PP) were acquired using pulse-contour derived cardiac index ( PiCCO-plus) , meanwhile central venous pressure ( CVP) , heart rate and blood pressure were measured at supine, baseline 1, during the EEO test, during passive leg raising, baseline 2 and after volume expansion (250 mL saline infused within 10 min).An increase of CI by 15% or more after volume expansion was defined volume responder.Results In contrast to nonresponders, CI and PP induced by EEO were increased significantly in responders (P<0.05).EEO-ΔCI and EEO-ΔPP were correlated positively with VE-ΔCI (r2 =0.914, P<0.001; r2 =0.75, P<0.001).AUC for EEO-ΔCI, EEO-ΔPP and PLR-ΔCI were 0.916 (95% CI 0.786~0.979), 0.816 (95% CI 0.664~0.919) and 0.964 (95%CI 0.780~1.000) respectively.EEO-ΔCI ≥4% predicted fluid responsiveness with a sensitivity of 92% and a specificity of 88%.EEO-ΔPP≥4% predicted fluid responsiveness with a sensitivity of 88%%and a specificity of 81%.PLR-ΔCI≥10%predicted fluid responsiveness with a sensitivity of 100%and a specificity of 86%.Conclusion EEO could serve as a reliable and feasible approach predicting volume responsiveness in mechanically ventilated patients with septic shock.
Keywords：End-expiratory occlusion( EEO)Fluid responsivenessPassive leg raising ( PLR)Heart-lung interactions
Publication Date：2015-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：9( 486-494 )