Pleth variability index to monitor the respiratory variations in the pulse oximeter plethysmographic waveform amplitude and predict fluid responsiveness in the operating theatre

Cannesson, Maxime; Desebbe, Olivier; Rosamel, P.; Delannoy, Bertrand; Robin, Jacques; Bastien, Olivier; Lehot, Jean‐Jacques

doi:10.1093/bja/aen133

Cited by 335 publications

(244 citation statements)

References 37 publications

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“…Studies have shown the usefulness of this noninvasive dynamic parameter in mechanically ventilated patients in the operating room and in the intensive care unit (ICU). 6,10,19 Conversely, other studies have concluded that PVI was of limited value in predicting fluid responsiveness in laparoscopic surgery 20 and in the ICU setting, respectively. 21 Several observations have shown the limitations of this parameter.…”

Section: Discussionmentioning

confidence: 97%

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Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters

Sebastiani

Philippi

Boehme

et al. 2012

Can J Anesth/J Can Anesth

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Background Interscalene nerve blocks provide adequate analgesia, but there are no objective criteria for early assessment of correct catheter placement. In the present study, pulse oximetry technology was used to evaluate changes in the perfusion index (PI) in both blocked and unblocked arms, and changes in the plethysmographic variability index (PVI) were evaluated once mechanical ventilation was instituted. Methods The PI and PVI values were assessed using a Radical-7 TM finger pulse oximetry device (Masimo Corp., Irvine, CA, USA) in both arms of 30 orthopedic patients who received an interscalene catheter at least 25 min before induction of general anesthesia. Data were evaluated at baseline, on application of local anesthetics; five, ten, and 15 min after onset of interscalene nerve blocks; after induction of general anesthesia; before and after a 500 mL colloid fluid challenge; and five minutes thereafter.

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Section: Discussionmentioning

confidence: 97%

“…9 The PI can be expressed by the following formula: PI = (AC/DC) x 100 [%]. 10 The value PVI is a noninvasive dynamic variable that reflects fluid status. It is calculated from the changes in PI over one or more complete respiratory cycles in mechanically ventilated patients using the following formula 10 :…”

Section: Measurementsmentioning

confidence: 99%

Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters

Sebastiani

Philippi

Boehme

et al. 2012

Can J Anesth/J Can Anesth

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“…PVI -это точный неинвазивный показатель ге-модинамического ответа на водную нагрузку у па-циентов, находящихся на искусственной вентиля-ции легких [19]. Имеются также данные о том, что вариабельность амплитуды пульсовой волны отра-жает преднагрузку у пациентов на спонтанном ды-хании [13,22,36].…”

Section: мониторинг г емодинамики особенности у новорож денныхunclassified

Hemodynamic monitoring on the background of intensive therapy in newborns

et al. 2017

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The article deals with the problem of early neonatal and infant mortality. It is pointed out that recent advances in emergency and intensive care therapy have provided decline in early neonatal and infant mortality. Hemodynamic disorders are reported to be associated with any severe pathology in patients of all age groups including newborns, significantly influence quality of life of patients having experienced a critical condition. Clinical manifestations of hemodynamic disorders in infants are not considered to be specific; they are critically delayed and are not timely recognized. The article describes peculiarities of the cardio-vascular system of newborns that are responsible for the necessity of thorough hemodynamic profile monitoring in order to provide detection of vital function alterations at the early stages, ensure timely onset of intensive therapy and its qualitative performance. Special attention is paid to current methods of determination of central hemodynamic parameters, which are stated to be divided into invasive and non-invasive. The paper also highlights some peculiarities of evaluation of hemodynamic findings using specific monitoring methods and factors influencing the outcome. The article specifies increased interest towards non-invasive monitoring tools of hemodynamic profile in recent years; their relevance is stated to be doubtless in both pediatric and neonatal practice. The main task of any monitoring procedure is reported to be hemodynamic findings analysis, “trend tracking” in the process of monitoring a patient and intensive therapy performance.

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“…[54][55][56][57][58] Solus-Biguenet et al, for instance, found a weak correlation of 0.29. 54 Nevertheless, despite this weak correlation, the majority of fluid responsiveness studies suggest that the respiratory variation in the PPG tracing is predictive of the hemodynamic response to fluid loading, [59][60][61][62][63] although this finding is not universal. 64,65 Surprisingly, despite the fact that the physiologic meaning of arterial respiratory variation has been understood for decades, extrapolation to the PPG waveform was completely missed by the manufacturers of pulse oximeters who considered this information ''noise'' and filtered it out through the application of high-pass filters.…”

Section: Fluid Responsivenessmentioning

confidence: 99%

Advances in photoplethysmography: beyond arterial oxygen saturation

Bartels

Thiele

2015

Can J Anesth/J Can Anesth

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Purpose Photoplethysmography permits continuous measurement of heart rate and peripheral oxygen saturation and has been widely used to inform clinical decisions. Recently, a myriad of noninvasive hemodynamic monitoring devices using this same technology have been increasingly available. This narrative review aims to summarize the principles that form the basis for the function of these devices as well as to comment on trials evaluating their accuracy and clinical application. Principal findings Advanced monitoring devices extend photoplethysmography technology beyond measuring oxygen concentration and heart rate. Quantification of respiratory variation of the photoplethysmographic waveform reflects respiratory variation of the arterial pressure waveform and can be used to gauge volume responsiveness. Both the volume-clamp and physiocal techniques are extensions of conventional photoplethysmography and permit continuous measurement of finger arterial blood pressure. Finger arterial pressure waveforms can subsequently inform estimations of cardiac output. Conclusions Although respiratory variations of the plethysmographic waveform correlate only modestly with the arterial blood pressure waveform, fluid responsiveness can be relatively consistently assessed using both approaches. Continuous blood pressure measurements obtained using the volume-clamp technique may be as accurate as conventional brachial noninvasive blood pressure measurements. Most importantly, clinical comparative effectiveness studies are still needed in order to determine if these technologies can be translated into improvement of relevant patient outcomes. RésuméObjectif La photopléthysmographie permet la mesure continue de la fréquence cardiaque et de la saturation en oxygène périphérique, et elle est largement utilisée pour les prises de décisions cliniques. Depuis peu, un très grand nombre de dispositifs non invasifs de surveillance hémodynamique utilisant la même technologie envahit le marché. Cette synthèse narrative vise à résumer les principes à la base du fonctionnement de ces dispositifs et à commenter les essais évaluant leur exactitude ainsi que leurs applications cliniques. Constatations principales Les dispositifs de surveillance avancée étendent la technologie de photopléthysmographie au-delà de la mesure de la concentration en oxygène et de la fréquence cardiaque. La quantification de la variation respiratoire du tracé photopléthysmographique reflète la variation respiratoire du tracé de pression artérielle et peut servir à jauger la réactivité au volume. Les deux techniques de compression volumique (volume-clamp) au doigt et la technique physiocal sont des prolongements de Author contributions Karsten Bartels wrote approximately 50% of the manuscript and critically edited the remainder. Robert H. Thiele wrote approximately 50% of the manuscript and critically edited the remainder.

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Pleth variability index to monitor the respiratory variations in the pulse oximeter plethysmographic waveform amplitude and predict fluid responsiveness in the operating theatre

Abstract: PVI, an automatic and continuous monitor of DeltaPOP, can predict fluid responsiveness non-invasively in mechanically ventilated patients during general anaesthesia. This index has potential clinical applications.

Cited by 335 publications

References 37 publications

Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters

Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters

Hemodynamic monitoring on the background of intensive therapy in newborns

Advances in photoplethysmography: beyond arterial oxygen saturation

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