Brachial Artery Peak Velocity Variation During The Valsalva Maneuver To Predict Fluid Responsiveness

Objective:To evaluate whether brachial artery peak velocity variation(AVP)while a Valsalva Maneuver(VM)could estimate fluid responsiveness in spontaneously breathing patients.Methods:Ninety-six patients required radial artery catheter for elective surgery of Ningbo Yinzhou People’s Hospital from December 2014 to June 2016 were enrolled.The brachial artery Doppler signal was recorded while the VM was performed,measure the AVP.Then begin the volume expansion(VE),measure the cardiac output variation(△CO)before and after VE.Pearson correlational analyses were conducted between AVP and ACO.Also the sensitivity and specificity of AVP were determined in predicting fluid responsiveness by the receiver operating characteristic(ROC)curve.Results:Patients were classified as group responders(n= 24)and group non-responders(n=72).Responder was defined as cardiac output increased≥15%after VE.The △VP correlated well with △CO(r=0.792,P<0.01).The ROC curve showed that a △VP cutoff of 33%could predict fluid responsiveness with a sensitivity of 87%and a specificity of 82%,the area under the curve is 0.903,(P<0.01).Conclusion:Brachial artery peak velocity variation during a Valsalva maneuver is a feasible method for predicting fluid responsiveness in spontaneously breathing patients.