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Pulse pressure variation and pleth variability index as predictors of fluid responsiveness in patients undergoing spinal surgery in the prone position
BACKGROUND: This study investigated the ability of pulse pressure variation (PPV) and pleth variability index (PVI) to predict fluid responsiveness of patients undergoing spinal surgery in the prone position. PATIENTS AND METHODS: A total of 53 patients undergoing posterior lumbar spinal fusion in t...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Dove Medical Press
2018
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038863/ https://www.ncbi.nlm.nih.gov/pubmed/30013353 http://dx.doi.org/10.2147/TCRM.S170395 |
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author | Kim, Do-Hyeong Shin, Seokyung Kim, Ji Young Kim, Seung Hyun Jo, Minju Choi, Yong Seon |
author_facet | Kim, Do-Hyeong Shin, Seokyung Kim, Ji Young Kim, Seung Hyun Jo, Minju Choi, Yong Seon |
author_sort | Kim, Do-Hyeong |
collection | PubMed |
description | BACKGROUND: This study investigated the ability of pulse pressure variation (PPV) and pleth variability index (PVI) to predict fluid responsiveness of patients undergoing spinal surgery in the prone position. PATIENTS AND METHODS: A total of 53 patients undergoing posterior lumbar spinal fusion in the prone position on a Jackson table were studied. PPV, PVI, and hemodynamic and respiratory variables were measured both before and after the administration of 6 mL/kg colloid in both the supine and prone positions. Fluid responsiveness was defined as a 15% or greater increase in stroke volume index, as assessed by esophageal Doppler monitor after fluid loading. RESULTS: In the supine position, 40 patients were responders. The areas under the receiver operating characteristic (ROC) curves for PPV and PVI were 0.783 [95% CI 0.648–0.884, P<0.001] and 0.814 (95% CI 0.684–0.908, P<0.001), respectively. The optimal cut-off values of PPV and PVI were 10% (sensitivity 75%, specificity 62%) and 8% (sensitivity 78%, specificity 77%), respectively. In the prone position, 27 patients were responders. The areas under the ROC curves for PPV and PVI were 0.781 (95% CI 0.646–0.883, P<0.001) and 0.756 (95% CI 0.618–0.863, P<0.001), respectively. The optimal cut-off values of PPV and PVI were 7% (sensitivity 82%, specificity 62%) and 8% (sensitivity 67%, specificity 69%), respectively. CONCLUSION: Both PPV and PVI were able to predict fluid responsiveness; their predictive abilities were maintained in the prone position. |
format | Online Article Text |
id | pubmed-6038863 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2018 |
publisher | Dove Medical Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-60388632018-07-16 Pulse pressure variation and pleth variability index as predictors of fluid responsiveness in patients undergoing spinal surgery in the prone position Kim, Do-Hyeong Shin, Seokyung Kim, Ji Young Kim, Seung Hyun Jo, Minju Choi, Yong Seon Ther Clin Risk Manag Original Research BACKGROUND: This study investigated the ability of pulse pressure variation (PPV) and pleth variability index (PVI) to predict fluid responsiveness of patients undergoing spinal surgery in the prone position. PATIENTS AND METHODS: A total of 53 patients undergoing posterior lumbar spinal fusion in the prone position on a Jackson table were studied. PPV, PVI, and hemodynamic and respiratory variables were measured both before and after the administration of 6 mL/kg colloid in both the supine and prone positions. Fluid responsiveness was defined as a 15% or greater increase in stroke volume index, as assessed by esophageal Doppler monitor after fluid loading. RESULTS: In the supine position, 40 patients were responders. The areas under the receiver operating characteristic (ROC) curves for PPV and PVI were 0.783 [95% CI 0.648–0.884, P<0.001] and 0.814 (95% CI 0.684–0.908, P<0.001), respectively. The optimal cut-off values of PPV and PVI were 10% (sensitivity 75%, specificity 62%) and 8% (sensitivity 78%, specificity 77%), respectively. In the prone position, 27 patients were responders. The areas under the ROC curves for PPV and PVI were 0.781 (95% CI 0.646–0.883, P<0.001) and 0.756 (95% CI 0.618–0.863, P<0.001), respectively. The optimal cut-off values of PPV and PVI were 7% (sensitivity 82%, specificity 62%) and 8% (sensitivity 67%, specificity 69%), respectively. CONCLUSION: Both PPV and PVI were able to predict fluid responsiveness; their predictive abilities were maintained in the prone position. Dove Medical Press 2018-07-06 /pmc/articles/PMC6038863/ /pubmed/30013353 http://dx.doi.org/10.2147/TCRM.S170395 Text en © 2018 Kim et al. This work is published and licensed by Dove Medical Press Limited The full terms of this license are available at https://www.dovepress.com/terms.php and incorporate the Creative Commons Attribution – Non Commercial (unported, v3.0) License (http://creativecommons.org/licenses/by-nc/3.0/). By accessing the work you hereby accept the Terms. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. |
spellingShingle | Original Research Kim, Do-Hyeong Shin, Seokyung Kim, Ji Young Kim, Seung Hyun Jo, Minju Choi, Yong Seon Pulse pressure variation and pleth variability index as predictors of fluid responsiveness in patients undergoing spinal surgery in the prone position |
title | Pulse pressure variation and pleth variability index as predictors of fluid responsiveness in patients undergoing spinal surgery in the prone position |
title_full | Pulse pressure variation and pleth variability index as predictors of fluid responsiveness in patients undergoing spinal surgery in the prone position |
title_fullStr | Pulse pressure variation and pleth variability index as predictors of fluid responsiveness in patients undergoing spinal surgery in the prone position |
title_full_unstemmed | Pulse pressure variation and pleth variability index as predictors of fluid responsiveness in patients undergoing spinal surgery in the prone position |
title_short | Pulse pressure variation and pleth variability index as predictors of fluid responsiveness in patients undergoing spinal surgery in the prone position |
title_sort | pulse pressure variation and pleth variability index as predictors of fluid responsiveness in patients undergoing spinal surgery in the prone position |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6038863/ https://www.ncbi.nlm.nih.gov/pubmed/30013353 http://dx.doi.org/10.2147/TCRM.S170395 |
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