Comparison of diagnostic values between stroke volume variation and central venous pressure in low circulatory blood volume of patients undergoing partial hepatectomy

Objective To explore the diagnostic values of stroke volume variation(SVV)and central venous pressure(CVP)in low circulatory blood volume by comparing the correlations between SVV,CVP and low circulatory blood volume.Methods 120patients undergoing partial hepatectomy were randomly selected.After general anesthesia with endotracheal intubation and the begining of the operation,nitroglycerin was administered to the patients via vein with three separate stages of the dosage regimen of 1,2,and 3μg·kg-1·min-1.The hemodynamic variables including stroke volume variation(SVV),central venous pressure(CVP),mean arterial pressure(MAP),heart rate(HR),stroke volume index(SVI),cardiac index(CI)and systemic vascular resistance index(SVRI)of the patients were detected at 4time points:before infusion(T0),15min after infusion of nitroglycerin 1μg·kg-1·min-1(T1),15 min after infusion of 2μg·kg-1·min-1 nitroglycerin(T2),15min after infusion of 3μg·kg-1·min-1 nitroglycerin(T3).The maximum of sensitivity and specificity and the receiver operating characteristic curve(AUC)of SVV and CVP responding to CI were detected by operating characteristic(ROC)curve;Pearson rank correlation method was used to analyze the correlation between SVV,CVP and CI.Results The AUC of SVV and CVP responding to CI were AUCCVP0.713(95%CI,0.623-0.804)and AUCSVV0.930(95%CI,0.883-0.977).When the SVV was 12.5%,the sum of sensitivity and specificity was the biggest with sensitivity of 81% and specificity of 95%;when the CVP was 5.5 mmHg,the sum of sensitivity and specificty was the biggest with sensitivity of 73%and specificity of 59%.The value of AUCSVV was larger than that of AUCCVP(P0.05).The values of Pearson's correlation coefficient of SVV,CVP and CI were rSVV-CI=-0.671(95%CI-0.455--0.67)and rCVP-CI=0.551(95%CI 0.744-0.591)and there were no significant difference between rSVV-CI and rCVP-CI(P0.05).Conclusion SVV and CVP are good parameters for diagnosis of low circulatory blood volume variation.The predictability of SVV for low circulatory blood volume is higher than CVP,and SVV is more sensitive and specific.