SavedAdd your journal

Journals / Anestezi Dergisi / 2020 / Cilt: 28 - Sayı: 1

Efficacy of Pleth Variability Index (PVI) to Evaluate Intraoperative Fluid Management During Orthopedic Spinal Surgery: A Randomized Controlled Trial

Ortopedik Spinal Cerrahi Olgularında İntraoperatif Sıvı Yönetimini Değerlendirmede Pleth Değişkenlik İndeksinin Etkinliği: Randomize Kontrollü Çalışma

Eralp ÇEVİKKALP
İsmet TOPÇU
Arzu AÇIKEL
Gönül TEZCAN KELEŞ
Semih SARILAR
Beyhan Cengiz ÖZYURT
Pages
18–25
Publication Date
2022-11-06
DOI
—
🏛️Bibliographic metadata and full text access for this article are provided via DergiPark.
DergiPark Record ↗
✨

AI Summary & Key Takeaways

AI Insight
⚡ TL;DR(Too Long; Didn't Read)

It can also provide more accurate results when evaluating intravascular volume status.

📌 3 Key Takeaways

🎯
Objective & Hypothesis:Objective: To prevent complications during major surgery, it is important to monitor blood andfluid treatment.
📊
Key Findings & Data:In our study, we aimed tocompare the management in terms of variations in PVI in response to fluid loading in the monitorization of intraoperative fluid management in major surgery using classical calculation method and CVPMethod: The patients were randomized into two equal (n=50) groups.
💡
Conclusion & Impact:It can also provide more accurate results when evaluating intravascular volume status.
🔬Design:Research Article
📍Scope:Comprehensive Sample
⚙️Variables:Domain Parameters

Abstract

Objective: To prevent complications during major surgery, it is important to monitor blood andfluid treatment. The Pleth Variability İndex (PVI) allows noninvasive assessment of fluid management. It is based on respiratory changes in arterial pulse pressure. In our study, we aimed tocompare the management in terms of variations in PVI in response to fluid loading in the monitorization of intraoperative fluid management in major surgery using classical calculation method and CVPMethod: The patients were randomized into two equal (n=50) groups. In Group C, the requiredamount of fluid replacement was carried out with crystalloid solutions using the 4-2-1 rule andby calculating fasting, maintenance, and insensible losses. In the PVI group, 250 mL of crystalloidsolution was administered in 5 minutes to patients with a PVI greater than 14%, patients with aPVI less than 14% were administered a fluid infusion with an initial dose of 4 mL kg-1 h-1.Results: In the comparison of intraoperative fluid management the amount of intraoperativefluid replacement was 3522±1098.1 mL in Group C and 1914±542.86 mL in Group PVI (p0.05).Conclusion: It has been thought that PVI assessment is more valuable than CVP monitoringbecause it is noninvasive and thus provides better cardiac stabilization with less fluid replacement. It can also provide more accurate results when evaluating intravascular volume status.

Özet

Amaç: Majör cerrahilerde komplikasyonları önlemek için, kan ve sıvı tedavisini izlemek önemlidir. “Pleth Değişkenlik İndeksi” (PDİ) sıvı tedavisinin invaziv olmayan ölçümüne olanak sağlayan, temeli arteriyel nabız basıncındaki solunumsal değişikliklere dayanan bir yöntemdir. Çalışmamızda, majör cerrahide intraoperatif sıvı yönetiminin, klasik hesaplama yöntemi ve SVB ile takibinin, sıvı yüklemesine verilen PVI değişikliklerine göre yönetimin karşılaştırılması amaçlanmıştır. Yöntem: Hastalar randomize olarak 2 eşit gruba (n=50) ayrıldı. Grup C’de sıvı gereksinimi açlık, idame ve insensibl kayıp 4-2-1 kuralına göre hesaplanarak kristalloid ile karşılandı. Grup PDİ’de PDİ değeri 14’ün üstünde olan hastalara 250 mL kristalloid 5 dk’da gidecek şekilde verildi. PDİ değeri 14’ün altında olan hastalara 4 mL kg-1 sa-1 sıvı infüzyonu açıldı. Bulgular: Grupların intraoperatif sıvı yönetimlerinin karşılaştırmasında; Grup C’de intraoperatif verilen sıvı miktarı 3522±1098.1 mL ve Grup PDİ de intraoperatif verilen sıvı miktarı 1914±542.86 ml (p

🔖

Cite This Article

ÇEVİKKALP, E., TOPÇU, İ., AÇIKEL, A., KELEŞ, G. T., SARILAR, S., ÖZYURT, B. C. (2022). Efficacy of Pleth Variability Index (PVI) to Evaluate Intraoperative Fluid Management During Orthopedic Spinal Surgery: A Randomized Controlled Trial. Anestezi Dergisi, Cilt: 28 - Sayı: 1, 18–25. https://ajindex.com/articles/648514

📄 Full Text PDF Viewer

📄

PDF görüntüleyici hazırlanıyor...

References (11)

  1. Van Regenmortel N, Jorens PG, Malbrain ML. Fluid management before, during and after elective surgery. Curr Opin Crit Care. 2014;20:390-5.
  2. Holte K, Sharrock NE, Kehlet H. Pathophysiology and clinical implications of perioperative fluid excess. Br J Anaesth. 2002;89:622-32.
  3. Feldman JM, Sussman E, Singh D, Friedman BJ. Is the pleth variability index a surrogate for pulse pressure variation in a pediatric population undergoing spine fusion? Paediatr Anaesth. 2012;22:250-5.
  4. Renner J, Broch O, Gruenewald M, et al. Non-invasive prediction of fluid responsiveness in infants using pleth variability index. Anaesthesia. 2011;66:582-9.
  5. Michard F. Changes in arterial pressure during mechanical ventilation. Anesthesiology. 2005;103:419-28.
  6. Perel A, Minkovich L, Preisman S, Abiad M, Segal E, Coriat P. Assessing fluid-responsiveness by a standardized ventilatory maneuver: the respiratory systolic variation test. Anesth Analg. 2005;100:942-5.
  7. Tavernier B, Makhotine O, Lebuffe G, Dupont J, Scherpereel P. Systolic pressure variation as a guide to fluid therapy in patients with sepsis-induced hypotension. Anesthesiology. 1998;89:1313-21.
  8. Sebastiani A, Philippi L, Boehme S et al. Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters. Can J Anaesth. 2012;59:1095-1101.
  9. Lopes MR, Oliveira MA, Pereira VO, Lemos IP, Auler JO Jr, Michard F. Goal-directed fluid management based on pulse pressure variation monitoring during highrisk surgery: a pilot randomized controlled trial. Crit Care. 2007;11:R100.
  10. Cannesson M, Delannoy B, Morand A et al. Does the Pleth variability index indicate the respiratory-induced variation in the plethysmogram and arterial pressure waveforms? Anesth Analg. 2008;106:1189-94.
  11. Stawicki SP, Kent A, Patil P et al. Dynamic behavior of venous collapsibility and central venous pressure during standardized crystalloid bolus: A prospective, observational, pilot study. Int J Crit Illn Inj Sci. 2015;5:80-4. https://doi.org/10.4103/2229-5151.158392 12.