Faculty Opinions recommendation of Goal-directed fluid management based on the pulse oximeter-derived pleth variability index reduces lactate levels and improves fluid management.

2015 ◽  
Author(s):  
Rebecca Schroeder
Keyword(s):  
Pulse Oximeter ◽  
Fluid Management ◽  
Pleth Variability Index ◽  
Variability Index ◽  
Lactate Levels

PLETH VARIABILITY INDEX-GUIDED FLUID THERAPY LOWERS POST-OPERATIVE LACTATE LEVELS IN DOGS UNDERGOING ELECTIVE ABDOMINAL SURGERY: A RANDOMIZED CONTROLLED TRIAL

2018 ◽  
Vol 44 (01) ◽  
pp. 7-14
Author(s):  
Chun-Hsiang Hu ◽  
Tien-Huan Hsu ◽  
Kuan-Sheng Chen ◽  
Wei-Ming Lee ◽  
Hsien-Chi Wang
Keyword(s):  
Abdominal Surgery ◽  
Fluid Therapy ◽  
Controlled Trial ◽  
Fluid Management ◽  
Tissue Perfusion ◽  
Control Group ◽  
Pleth Variability Index ◽  
Elective Abdominal Surgery ◽  
Variability Index ◽  
Lactate Levels

To evaluate the hemodynamic optimization effect of pleth variability index (PVI)-guided fluid therapy during abdominal surgery on tissue perfusion, 19 client-owned dogs that underwent elective abdominal surgery were randomized into control ([Formula: see text]) and PVI ([Formula: see text]) groups. In the control group, perioperative fluid management was based on the 2013 AAHA/AAFP Fluid Therapy Guidelines for Dogs and Cats. In the PVI group, the fluid rate was maintained based on basic daily requirements. If PVI was higher than 15% for [Formula: see text][Formula: see text]min, 3–5[Formula: see text]mL/kg of crystalloid fluid bolus was infused. The tissue perfusion indicator, lactate levels, was measured at the time of intubation, extubation, and 6, 12 and 24[Formula: see text]h postoperatively. There were no significant differences in total and average fluid infused between control and PVI groups. The control group had significantly higher lactate levels than that of the PVI group at 12[Formula: see text]h postoperatively ([Formula: see text][Formula: see text]mmol/L versus [Formula: see text][Formula: see text]mmol/L, [Formula: see text]) and overall postoperatively ([Formula: see text][Formula: see text]mmol/L versus [Formula: see text][Formula: see text]mmol/L, [Formula: see text]). The control group revealed more profound hemodilution, as indicated by significantly decreased postoperative blood urea nitrogen (BUN), creatinine, and total protein. PVI-guided fluid therapy lowers lactate levels after elective abdominal surgery in dogs. Therefore, based on the result of this study PVI may provide customized fluid therapy to improve tissue perfusion and avoid unnecessary fluid overload.

scholarly journals Pleth variability index and fluid management practices: a multicenter service evaluation

2021 ◽  
Vol 14 (1) ◽  
Author(s):  
Patrice Forget ◽  
Simon Lacroix ◽  
Eric P. Deflandre ◽  
Anne Pirson ◽  
Nicolas Hustinx ◽  
...  
Keyword(s):  
Management Practices ◽  
New Technology ◽  
Fluid Management ◽  
Service Evaluation ◽  
Pleth Variability Index ◽  
Clinical Practices ◽  
Non Invasive ◽  
Before And After ◽  
Variability Index

Abstract Objectives The introduction of a new technology has the potential to modify clinical practices, especially if easy to use, reliable and non-invasive. This observational before/after multicenter service evaluation compares fluid management practices during surgery (with fluids volumes as primary outcome), and clinical outcomes (secondary outcomes) before and after the introduction of the Pleth Variability Index (PVI), a non-invasive fluid responsiveness monitoring. Results In five centers, 23 anesthesiologists participated during a 2-years period. Eighty-eight procedures were included. Median fluid volumes infused during surgery were similar before and after PVI introduction (respectively, 1000 ml [interquartile range 25–75 [750–1700] and 1000 ml [750–2000]). The follow-up was complete for 60 from these and outcomes were similar. No detectable change in the fluid management was observed after the introduction of a new technology in low to moderate risk surgery. These results suggest that the introduction of a new technology should be associated with an implementation strategy if it is intended to be associated with changes in clinical practice.

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

2019 ◽  
Author(s):  
Tianyu Liu ◽  
Chao Xu ◽  
Min Wang ◽  
Zheng Niu ◽  
Dun yi Qi
Keyword(s):  
Meta Analysis ◽  
Fluid Management ◽  
Cochrane Library ◽  
Youden Index ◽  
Pleth Variability Index ◽  
Mechanically Ventilated ◽  
Mechanically Ventilated Patients ◽  
Preload Responsiveness ◽  
Variability Index ◽  
Ventilated Patients

Abstract Background: Goal-directed volume expansion is increasingly used for fluid management in mechanically ventilated patients. The Pleth Variability Index (PVI) has been shown to reliably predict preload responsiveness; however, a lot of research on PVI has been published recently, and new meta-analysis needs to be updated. Methods: We searched PUBMED, EMBASE, Cochrane Library, Web of Science (updated to November 7, 2018) and the associated references. We also contacted relevant authors and researchers. Results: Twenty-five studies with 975 patients were included in this meta-analysis. All patients were mechanically ventilated. The pooled area under the receiver operating characteristic (AUC) to predict preload responsiveness in patients was 0.82 (95% confidence interval (CI) 0.79 - 0.85). The pooled sensitivity was 0.77 (95% CI 0.67-0.85) and the pooled specificity was 0.77 (95% CI 0.71-0.82). The results of the without undergoing surgery subgroup (AUC =0.86, Youden index =0.65) and ICU subgroup (AUC =0.89, Youden index =0.67) were reliable. Conclusion: The reliability of the PVI is limited, but the PVI can plays an important role in bedside monitoring for mechanically ventilated patients who are not undergoing surgery. Keywords: Pleth variability index, Preload responsiveness, Mechanically ventilated patients, Meta-analysis.

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