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SVV Fluid Responsiveness — FRCA Final MCQ

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ModeratePerioperative MedicineSVV Fluid ResponsivenessFRCA Final

A 62-year-old man (ASA III) is undergoing an elective right hemicolectomy. He has a thoracic epidural at T9/10. Goal-directed fluid therapy is being used with oesophageal Doppler monitoring. The stroke volume variation (SVV) is 18%. What does this indicate?

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Correct answer: D — The patient is adequately volume-loaded

Stroke volume variation (SVV) >12-13% in a mechanically ventilated patient (in sinus rhythm, VT ≥8 mL/kg) suggests fluid responsiveness – meaning a fluid bolus (typically 250 mL crystalloid) is likely to increase cardiac output. SVV reflects the interaction between positive pressure ventilation and venous return; in a hypovolaemic patient, the ventilator-induced preload variation causes greater fluctuation in stroke volume. An SVV of 18% suggests likely fluid responsiveness. HOWEVER, SVV is unreliable in: spontaneous breathing, arrhythmias (especially AF), open-chest surgery, and low tidal volumes (<8 mL/kg).

Reference: RCOA – 2023 – Goal-directed fluid therapy; Perioperative Quality Improvement Programme (PQIP)