Academic Journal
The predictive value of tidal volume challenge-induced hemodynamic changes for fluid responsiveness in patients undergoing thoracoscopic surgery with one-lung ventilation: a prospective observational study.
| Τίτλος: | The predictive value of tidal volume challenge-induced hemodynamic changes for fluid responsiveness in patients undergoing thoracoscopic surgery with one-lung ventilation: a prospective observational study. |
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| Συγγραφείς: | Zhan Y; Department of Anesthesiology, Fuyang Affiliated Hospital of Anhui Medical University, Fuyang, 236000, China., Zhang QQ; Department of Anesthesiology, Fuyang Affiliated Hospital of Anhui Medical University, Fuyang, 236000, China., Wang XQ; Department of Anesthesiology, Fuyang Affiliated Hospital of Anhui Medical University, Fuyang, 236000, China., Yuan H; Department of Anesthesiology, Fuyang Affiliated Hospital of Anhui Medical University, Fuyang, 236000, China., Li JQ; Department of Anesthesiology, Fuyang Affiliated Hospital of Anhui Medical University, Fuyang, 236000, China. lijunqing005@126.com. |
| Πηγή: | BMC anesthesiology [BMC Anesthesiol] 2026 Mar 07; Vol. 26 (1). Date of Electronic Publication: 2026 Mar 07. |
| Τύπος έκδοσης: | Journal Article; Observational Study |
| Γλώσσα: | English |
| Στοιχεία περιοδικού: | Publisher: BioMed Central Country of Publication: England NLM ID: 100968535 Publication Model: Electronic Cited Medium: Internet ISSN: 1471-2253 (Electronic) Linking ISSN: 14712253 NLM ISO Abbreviation: BMC Anesthesiol Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: [London] : BioMed Central, 2001- |
| Ιατρικοί όροι (MeSH): | Tidal Volume*/physiology , One-Lung Ventilation*/methods , Hemodynamics*/physiology , Fluid Therapy*/methods , Thoracic Surgery, Video-Assisted*/methods, Humans ; Prospective Studies ; Female ; Male ; Middle Aged ; Predictive Value of Tests ; Stroke Volume |
| Περίληψη: | Background: Video-assisted thoracic surgery (VATS) relies on one-lung ventilation (OLV) to achieve optimal surgical conditions. However, the lung protective ventilation strategies commonly employed during OLV diminish the accuracy of traditional dynamic parameters in predicting fluid responsiveness. The tidal volume challenge (TVC) has been proposed to overcome this limitation, yet its effectiveness in OLV patients remains to be validated. In this study, we used LiDCO to evaluate TVC-induced changes in SVV(ΔSVV_TVC) and PPV(ΔPPV_TVC), and assessed their ability to predict fluid responsiveness in patients receiving lung-protective OLV during VATS. Methods: All patients received OLV in lateral position after general anesthesia induction. Upon achieving hemodynamic stability, the study protocol was initiated. Hemodynamic and respiratory parameters, including heart rate, mean arterial pressure, stroke volume variation (SVV), pulse pressure variation (PPV), stroke volume index (SVI), cardiac index, peak inspiratory pressure, and dynamic lung compliance were recorded at four time points: before TVC (T Results: Among the 60 patients, 26 (43%) were fluid responders. ROC analysis showed that the area under the curve (AUC) of ΔSVV_TVC for predicting fluid responsiveness was 0.83 (95% CI, 0.71-0.91), with an optimal cutoff value of > 2%, sensitivity of 77%, specificity of 76%, and a gray zone range of 1%-3% encompassing 23 patients (38%). For ΔPPV_TVC, the AUC was 0.86 (95% CI, 0.74-0.93), with a cutoff of > 3%, sensitivity of 85%, specificity of 80%, and a gray zone of 2%-4% including 13 patients (22%).Subgroup analysis revealed no significant difference in the predictive AUC values of ΔSVV_TVC or ΔPPV_TVC between the left and right lateral decubitus positions. Conclusion: Tidal volume challenge -induced changes in SVV and PPV effectively predict fluid responsiveness in OLV patients, and their predictive performance is not influenced by patient position. Trial Registration: This trial was registered with Chinese Clinical Trial Registry, ChiCTR2300075285, August 31, 2023. (© 2026. The Author(s).) |
| Competing Interests: | Declarations. Ethics approval and consent to participate: This study was performed according to the Declaration of Helsinki after the approval of the Ethics Committee of the Fuyang Affiliated Hospital of Anhui Medical University (approval number: KY2023058) and registered in the Chinese Clinical Trial Register (registration number: ChiCTR2300075285). Written informed consent was obtained from all participants. Consent for publication: Not applicable. Competing interests: The authors declare no competing interests. |
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| Grant Information: | FSK2024093 Fuyang City 2024 Social Science Planning Project Funded Project |
| Contributed Indexing: | Keywords: One-lung ventilation; Pulse pressure variation; Stroke volume variation; Tidal volume challenge; Volume loading test |
| Entry Date(s): | Date Created: 20260307 Date Completed: 20260710 Latest Revision: 20260813 |
| Update Code: | 20260813 |
| PubMed Central ID: | PMC13081299 |
| DOI: | 10.1186/s12871-026-03741-y |
| PMID: | 41794706 |
| Βάση Δεδομένων: | MEDLINE |
| ISSN: | 1471-2253 |
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| DOI: | 10.1186/s12871-026-03741-y |