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Oesophageal Doppler and calibrated pulse contour analysis are not interchangeable within a goal-directed haemodynamic algorithm in major gynaecological.

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Presentation on theme: "Oesophageal Doppler and calibrated pulse contour analysis are not interchangeable within a goal-directed haemodynamic algorithm in major gynaecological."— Presentation transcript:

1 Oesophageal Doppler and calibrated pulse contour analysis are not interchangeable within a goal-directed haemodynamic algorithm in major gynaecological surgery†  A. Feldheiser, O. Hunsicker, H. Krebbel, K. Weimann, L. Kaufner, K.-D. Wernecke, C. Spies  British Journal of Anaesthesia  Volume 113, Issue 5, Pages (November 2014) DOI: /bja/aeu241 Copyright © 2014 The Author(s) Terms and Conditions

2 Fig 1 Evaluation of change of SV between monitors comparing SV changes during initial fluid challenge after establishing the haemodynamic monitors at the beginning of surgery during haemodynamic stable conditions. Data are shown as median (25%; 75% quartiles). The exact Mann–Whitney test for independent groups was used to compare the change of SV. *Statistical significance P=0.003. British Journal of Anaesthesia  , DOI: ( /bja/aeu241) Copyright © 2014 The Author(s) Terms and Conditions

3 Fig 2 Four-quadrant plot assessing trending of SV (agreement of SV changes) during a fluid challenge between ODM and PCA regarding all fluid challenges performed. The exclusion zone size was calculated implying the combined LSC of ODM and PCA. The shaded area visualizes the two quadrants including the paired ΔSVI values with the same directional change. The dashed diagonal line represents the line of identity (x=y). British Journal of Anaesthesia  , DOI: ( /bja/aeu241) Copyright © 2014 The Author(s) Terms and Conditions

4 Fig 3 Polar plots assessing trending of SV changes during a fluid challenge between ODM and PCA regarding all fluid challenges performed (a) and fluid challenges with different types of study fluid: balanced crystalloid (b); balanced colloid (c); and FFP (d). Radial ULOA, radial upper limit of agreement (bias+1.96 sd); Radial LLOA, radial lower limit of agreement (bias−1.96 sd). The exclusion zone size was calculated implying the combined LSC of ODM and PCA. The shaded area (defined by RLOAs and boundary limits) visualizes the magnitude of non-agreement between ODM and PCA. The angular concordance rate between fluid challenges performed with balanced crystalloid, balanced colloid, and FFP was not significantly different (NS; P=0.592). British Journal of Anaesthesia  , DOI: ( /bja/aeu241) Copyright © 2014 The Author(s) Terms and Conditions

5 Fig 4 Forest plot visualizing the association of pre- and intraoperative characteristics with trending between ODM and PCA by presenting ORs obtained from multivariate logistic GEE. ORs are drawn on a logarithmic scale and are adjusted for all other covariates. Regarding the clinical interpretation, ORs of temperature, remifentanil, NE, and changes of MAP were scaled for changes of 0.1°C, 0.1 µg kg−1 min−1, and 10%. The covariate duration of surgery was not associated with trending (P=0.15) and was not shown due to the better illustration of all other covariates. British Journal of Anaesthesia  , DOI: ( /bja/aeu241) Copyright © 2014 The Author(s) Terms and Conditions


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