Assessment of hemodynamic parameters for predicting fluid responsiveness in neurosurgery

Objective To assess the ability of different hemodynamic parameters to predict fluid responsiveness in neurosurgical patients.Methods Twenty-five patients undergoing craniotomy were enrolled.Fluid boluses of 250 mL 6% hydroxyethyl starch 130/0.4 were administered in 10 minutes after induction of anesthesia.Haemodynamic variables were recorded before and after fluid bolus application,including heart rate(HR),mean arterial pressure(MAP),central venous pressure(CVP),stroke volume variation(SVV),systemic vascular resistance index(SVRI)and stroke volume index(SVI).Fluid responsiveness was defined as an increase in SVI no less than 10%.Results Seventeen patients were responsers to volume expansion(VE) and eight patients were non-responsers.CVP and SVI increased significantly after VE(all P0.01),whereas stroke SVV and SVRI decreased significantly(all P0.01).Responsers and non-responsers differed in their pre-VE values of SVV(P0.01).Threshold SVV value of 12.5% allowed discrimination of responsers to VE with a sensitivity of 80% and a specificity of 100%.Conclusions SVV predicts fluid responsiveness precisely during neurosurgery.