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Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study
BACKGROUND: The plethysmography variability index (PVI) is a non-invasive, real-time, and automated parameter for evaluating fluid responsiveness, but it does not reliably predict fluid responsiveness during low tidal volume (V(T)) ventilation. We hypothesized that in a ‘tidal volume challenge’ with...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Springer Netherlands
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10520182/ https://www.ncbi.nlm.nih.gov/pubmed/36933167 http://dx.doi.org/10.1007/s10877-023-00977-8 |
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author | Botros, J. M. Salem, Y. S. M. Khalil, M. Algyar, M. F. Yassin, H. M. |
author_facet | Botros, J. M. Salem, Y. S. M. Khalil, M. Algyar, M. F. Yassin, H. M. |
author_sort | Botros, J. M. |
collection | PubMed |
description | BACKGROUND: The plethysmography variability index (PVI) is a non-invasive, real-time, and automated parameter for evaluating fluid responsiveness, but it does not reliably predict fluid responsiveness during low tidal volume (V(T)) ventilation. We hypothesized that in a ‘tidal volume challenge’ with a transient increase in tidal volume from 6 to 8 ml Kg(− 1), the changes in PVI could predict fluid responsiveness reliably. METHOD: We performed a prospective interventional study in adult patients undergoing hepatobiliary or pancreatic tumor resections and receiving controlled low V(T) ventilation. The values for PVI, perfusion index, stroke volume variation, and stroke volume index (SVI) were recorded at baseline V(T) of 6 ml Kg(− 1), 1 min after the V(T) challenge (8 ml Kg(− 1)), 1 min after V(T) 6 ml Kg(− 1) reduced back again, and then 5 min after crystalloid fluid bolus 6 ml kg(− 1) (actual body weight) administered over 10 min. The fluid responders were identified by SVI rise ≥ 10% after the fluid bolus. RESULTS: The area under the receiver operating characteristic curve for PVI value change (ΔPVI(6–8)) after increasing V(T) from 6 to 8 ml Kg(− 1) was 0.86 (95% confidence interval, 0.76–0.96), P < 0.001, 95% sensitivity, 68% specificity, and with best cut-off value of absolute change (ΔPVI(6–8)) = 2.5%. CONCLUSION: In hepatobiliary and pancreatic surgeries, tidal volume challenge improves the reliability of PVI for predicting fluid responsiveness and changes in PVI values obtained after tidal volume challenge are comparable to the changes in SVI. |
format | Online Article Text |
id | pubmed-10520182 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Springer Netherlands |
record_format | MEDLINE/PubMed |
spelling | pubmed-105201822023-09-27 Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study Botros, J. M. Salem, Y. S. M. Khalil, M. Algyar, M. F. Yassin, H. M. J Clin Monit Comput Original Research BACKGROUND: The plethysmography variability index (PVI) is a non-invasive, real-time, and automated parameter for evaluating fluid responsiveness, but it does not reliably predict fluid responsiveness during low tidal volume (V(T)) ventilation. We hypothesized that in a ‘tidal volume challenge’ with a transient increase in tidal volume from 6 to 8 ml Kg(− 1), the changes in PVI could predict fluid responsiveness reliably. METHOD: We performed a prospective interventional study in adult patients undergoing hepatobiliary or pancreatic tumor resections and receiving controlled low V(T) ventilation. The values for PVI, perfusion index, stroke volume variation, and stroke volume index (SVI) were recorded at baseline V(T) of 6 ml Kg(− 1), 1 min after the V(T) challenge (8 ml Kg(− 1)), 1 min after V(T) 6 ml Kg(− 1) reduced back again, and then 5 min after crystalloid fluid bolus 6 ml kg(− 1) (actual body weight) administered over 10 min. The fluid responders were identified by SVI rise ≥ 10% after the fluid bolus. RESULTS: The area under the receiver operating characteristic curve for PVI value change (ΔPVI(6–8)) after increasing V(T) from 6 to 8 ml Kg(− 1) was 0.86 (95% confidence interval, 0.76–0.96), P < 0.001, 95% sensitivity, 68% specificity, and with best cut-off value of absolute change (ΔPVI(6–8)) = 2.5%. CONCLUSION: In hepatobiliary and pancreatic surgeries, tidal volume challenge improves the reliability of PVI for predicting fluid responsiveness and changes in PVI values obtained after tidal volume challenge are comparable to the changes in SVI. Springer Netherlands 2023-03-18 2023 /pmc/articles/PMC10520182/ /pubmed/36933167 http://dx.doi.org/10.1007/s10877-023-00977-8 Text en © The Author(s) 2023. Springer Nature or its licensor (e.g. a society or other partner) holds exclusive rights to this article under a publishing agreement with the author(s) or other rightsholder(s); author self-archiving of the accepted manuscript version of this article is solely governed by the terms of such publishing agreement and applicable law. https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Original Research Botros, J. M. Salem, Y. S. M. Khalil, M. Algyar, M. F. Yassin, H. M. Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study |
title | Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study |
title_full | Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study |
title_fullStr | Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study |
title_full_unstemmed | Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study |
title_short | Effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study |
title_sort | effects of tidal volume challenge on the reliability of plethysmography variability index in hepatobiliary and pancreatic surgeries: a prospective interventional study |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10520182/ https://www.ncbi.nlm.nih.gov/pubmed/36933167 http://dx.doi.org/10.1007/s10877-023-00977-8 |
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