Technical Track D, Healthcare: Novel Calculation of Pulse Pressure Variation Can Reliably Predict Fluid Responsiveness in the NICU by Zachary Foughty
Current techniques for estimating fluid responsiveness have limited utility in the Neonatal Intensive Care Unit (NICU). We evaluated whether advanced techniques for calculating pulse pressure variation (PPV) could reliably predict fluid responsiveness in neonates. Data were obtained from 74 patients in the NICU who received packed red blood cell (pRBC) transfusions and had an arterial catheter for invasive arterial blood pressure (ABP) monitoring. To calculate PPV, a Fast Fourier Transform convolution-based technique was applied to ABP data at baseline and at various time intervals after the start of 169 separate pRBC transfusions. Cardiac output was estimated by change in PPV from baseline. We constructed a prediction model and used logistic regression to analyze baseline PPV as a predictor of cardiac output. Analysis of the prediction model showed a ROC AUC = 0.89 for the period 30 to 60 minutes after start of transfusion. Based on this, novel techniques for calculating PPV can reliably predict fluid responsiveness in neonates.
Authors: Zachary Foughty, Onur Tavaslioglu, Christopher Rhee, Leah Elizondo, Craig Rusin, Sebastian Acosta, Baylor College of Medicine; Danielle Rios, University of Iowa Carver College of Medicine
