Poor Agreement between Respiratory Variations in Pulse Oximetry Photoplethysmographic Waveform Amplitude and Pulse Pressure in Intensive Care Unit Patients

Abstract

A large variability of DeltaPOP and a poor agreement between DeltaPP and DeltaPOP limits DeltaPOP as a tool for evaluation of fluid responsiveness in intensive care unit patients. This is in contrast to DeltaPP, which shows a small variability.

Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia?

“…Therefore, we believe that this is also one of the most probable reasons the PVI did not change significantly after the start of pneumoperitoneum in the present study. Furthermore, the mechanism of PI increase and PVI decrease after release of pneumoperitoneum in the present study owes to the decrease of sympathetic activity induced by the pneumoperitoneum (11,(32)(33)(34).…”

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

“…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. It seems to be difficult to define a clear threshold value to discriminate between responders and non-responders to a fluid bolus, with variations from 12-17% among the studies and settings being described.…”

Inter-device differences in monitoring for goal-directed fluid therapy

“…[82][83][84][85] Despite the growing body of data suggesting that PVI is capable of predicting fluid responsiveness, there does not seem to be strong agreement between PVI and PPV. [86][87][88][89][90] The reasons for this paradox (excellent predictor of fluid responsiveness yet not in agreement with arterial-derived metrics) are not clear but may be related to the dependence of PVI on perfusion. 91 While the Masimo device may not be as effective as its more invasive counterparts during periods of malperfusion, it has three major advantages -relative low cost in comparison with its competitors, the ubiquity of pulse oximetry (which of course is a Canadian Anesthesiologists' Society basic monitoring standard), 92 and ease of use.…”