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Global end-diastolic volume and global end-diastolic volume index are age dependent in awake, spontaneous-breathing patients after elective craniotomy

Introduction

Estimation of cardiac preload is an important prerequisite for adequate volume resuscitation. The global end-diastolic volume (GEDV) and the global end-diastolic volume index (GEDVI) are surrogate parameters for preload and have been hypothesized to be age dependent [1]. The current study was performed to assess the influence of age on the preload parameters GEDV and GEDVI prospectively.

Methods

One hundred and one patients (41 male, 60 female) scheduled for brain tumour surgery were investigated using the PiCCOplus device (Pulsion Medical Systems AG, Munich, Germany). On postoperative day 1, the cardiac output, GEDV and GEDVI were determined by transpulmonary thermodilution before discharge from the ICU. The influence of predefined age groups (21 to 40 years old, n = 12; 41 to 50 years old, n = 24; 51 to 60 years old, n = 20; 61 to 70 years old, n = 26; 71 to 83 years old, n = 19) was tested using a Kruskal–Wallis test. The level of significance was 5%.

Results

Age significantly influenced the GEDV (P = 0.0024) as well as the GEDVI (P = 0.0007). Cardiac output (P = 0.3555), mean arterial pressure (P = 0.0764) and systemic vascular resistance (P = 0.1446) were not dependent on age.

Conclusion

The volumetric parameter GEDV is dependent on age in haemodynamically healthy and spontaneously breathing patients. Indexing to body surface area does not remove age dependence. Targeting volume resuscitation using fixed ranges of the GEDVI acquired by transpulmonary thermodilution without reference to the patient's age seems not to be appropriate.

Table 1 GEDV in age groups

References

  1. 1.

    Wolf S, et al.: ITBV and GEDV but not EVLW acquired by transpulmonary thermodilution is age dependent in a series of neurosurgical patients [poster]. Intensive Care Med 2007,33(S2):P0273.

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Rieß, A., Wolf, S., Landscheidt, J. et al. Global end-diastolic volume and global end-diastolic volume index are age dependent in awake, spontaneous-breathing patients after elective craniotomy. Crit Care 13, P216 (2009). https://doi.org/10.1186/cc7380

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Keywords

  • Cardiac Output
  • Systemic Vascular Resistance
  • Volume Resuscitation
  • Transpulmonary Thermodilution
  • Cardiac Preload