Reliability of pleth variability index in predicting preload responsiveness of mechanically ventilated patients under various conditions: a systematic review and meta-analysis

Li, Tianyu; Chen, Xu; Wang, Min; Niu, Zheng; Qi, Dun yi

doi:10.1186/s12871-019-0744-4

Cited by 28 publications

(15 citation statements)

References 46 publications

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“…Furthermore, in this study, PI LRM had better ability to indicate fluid responders than PVI at baseline. This finding is similar to that of a previous meta-analysis (39), which reported that PVI reliability to predict fluid responsiveness in surgical patients under mechanical ventilators might be reduced. Nevertheless, further studies should be performed to validate these findings.…”

Section: Correlation Of Pi Lrm Pvi Pi and Ppv T1 With Changes In Svsupporting

confidence: 91%

Prediction of Fluid Responsiveness by the Effect of the Lung Recruitment Maneuver on the Perfusion Index in Mechanically Ventilated Patients During Surgery

et al. 2022

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IntroductionExcessive or inadequate fluid administration during perioperative period affects outcomes. Adjustment of volume expansion (VE) by performing fluid responsiveness (FR) test plays an important role in optimizing fluid infusion. Since changes in stroke volume (SV) during lung recruitment maneuver (LRM) can predict FR, and peripheral perfusion index (PI) is related to SV; therefore, we hypothesized that the changes in PI during LRM (ΔPILRM) could predict FR during perioperative period.MethodsPatients who were scheduled for elective non-laparoscopic surgery under general anesthesia with a mechanical ventilator and who required VE (250 mL of crystalloid solution infusion over 10 min) were included. Before VE, LRM was performed by a continuous positive airway pressure of 30 cm H2O for 30 sec; hemodynamic variables with their changes (PI, obtained by pulse oximetry; and ΔPILRM, calculated by using [(PI before LRM—PI after LRM)/PI before LRM]*100) were obtained before and after LRM. After SV (measured by esophageal doppler) and PI had returned to the baseline values, VE was infused, and the values of these variables were recorded again, before and after VE. Fluid responders (Fluid-Res) were defined by an increase in SV ≥10% after VE. Receiver operating characteristic curves of the baseline values and ΔPILRM were constructed and reported as areas under the curve (AUC) with 95% confidence intervals, to predict FR.ResultsOf 32 mechanically ventilated adult patients included, 13 (41%) were in the Fluid-Res group. Before VE and LRM, there were no differences in the mean arterial pressure (MAP), heart rate, SV, and PI between patients in the Fluid-Res and fluid non-responders (Fluid-NonRes) groups. After LRM, SV, MAP, and, PI decreased in both groups, ΔPILRM was greater in the Fluid-Res group than in Fluid-NonRes group (55.2 ± 17.8% vs. 35.3 ± 17.3%, p < 0.001, respectively). After VE, only SV and cardiac index increased in the Fluid-Res group. ΔPILRM had the highest AUC [0.81 (0.66–0.97)] to predict FR with a cut-off value of 40% (sensitivity 92.3%, specificity 73.7%).ConclusionsΔPILRM can be applied to predict FR in mechanical ventilated patients during the perioperative period.

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Section: Correlation Of Pi Lrm Pvi Pi and Ppv T1 With Changes In Svsupporting

confidence: 91%

Prediction of Fluid Responsiveness by the Effect of the Lung Recruitment Maneuver on the Perfusion Index in Mechanically Ventilated Patients During Surgery

et al. 2022

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“…PPV is an index for evaluating the volume status of patients undergoing mechanical ventilation under general anesthesia and judging their volume responsiveness based on the mechanism of the cardiopulmonary interaction. It is a dynamic index and has recently been viewed for the commonly used indicators of anesthesia volume management 24,25 . Renner et al .…”

Section: Discussionmentioning

confidence: 99%

The Safety Assessment of Irrigation Fluid Management for Shoulder Arthroscopy and Its Effect on Postoperative Efficacy

Zhuang

Yang

et al. 2022

Orthopaedic Surgery

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Background context: With the popularity of shoulder arthroscopy, the releted complications have recently studied, among which the excessive uid extravasation is a potentially dangerous complication. Most relevant studies involve respiratory system, while the reports fouced on the cardiovascular system and postoperative function recovery are rare. The objective is to reveal the effects of the excessive uid extravasation on cardiovascular system and postoperative function Method: A retrospective analysis was made on the clinical data of 92 patients, in whom 84 cases of rotator cuff injury, 3 cases of shoulder instability, 3 cases of fracture of the greater tuberosity of the humerus, and 2 cases of frozen shoulder. The basic information of the patients, ASES and VAS scores in each period before and after surgery, cardiac index (CI) and pulse pressure variation (PPV) before and after anesthesia, and changes in arm circumference and deltoid muscle circumference before and after surgery were recorded and evaluated.Result: The preoperative CI was affected by changes in anesthesia status and body position, while PPV is not affected by anesthesia and body position. Multivariate mixed-effects model analysis of CI found that there was a statistically signi cant difference between patients older than 55 years old and those with obesity (BMI>24). After the operation, the retention of irrigation iud had an effect on the circumference of the deltoid, neck and arm, but the effect on the circumference of the deltoid was statistically signi cant (P<0.001 (95%CI: [0.30, 1.00]). The multivariate analysis of ASES scores at 3 and 6 months after surgery showed that the uid retention volume was correlated with the ASES score at 3 months after surgery, especially when the retention volume was greater than 2L (P=0.001 (95%). %CI: [-12.49,-3.22]). Conclusion:The retention of irrigation iud after shoulder arthroscopic surgery causes swelling of local limbs, and also has a certain effect on peripheral blood vessels, which is mainly re ected in its in uence on PPV and the postoperation function. Therefore, the surgeon needs to improve the surgical technique, shorten the operation time and reduce the uid retention.

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“…A recent meta-analysis by Liu et al highlighted the wide range of PVI cut-off value (from 7% to 20%), depending on the studied population and ventilation settings (e.g., ICU, or, tidal volume, positive end expiratory pressure…) to predict fluid responsiveness [69].…”

Section: Pi Respiratory Variations and Prediction Of Fluid Responsivenessmentioning

confidence: 99%

Perfusion index: Physical principles, physiological meanings and clinical implications in anaesthesia and critical care

Coutrot

Dudoignon

Joachim

et al. 2021

Anaesthesia Critical Care & Pain Medicine

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Reliability of pleth variability index in predicting preload responsiveness of mechanically ventilated patients under various conditions: a systematic review and meta-analysis

Cited by 28 publications

References 46 publications

Prediction of Fluid Responsiveness by the Effect of the Lung Recruitment Maneuver on the Perfusion Index in Mechanically Ventilated Patients During Surgery

Prediction of Fluid Responsiveness by the Effect of the Lung Recruitment Maneuver on the Perfusion Index in Mechanically Ventilated Patients During Surgery

The Safety Assessment of Irrigation Fluid Management for Shoulder Arthroscopy and Its Effect on Postoperative Efficacy

Perfusion index: Physical principles, physiological meanings and clinical implications in anaesthesia and critical care

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