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Evaluating the Relationship between the Pleth Variability Index and Hypotension and Assessing the Fluid Response in Geriatric Hip Fracture under Spinal Anaesthesia: An Observational Study

OBJECTIVE: We aimed to test the efficacy of the pre-operative Pleth variability index (PVI) in evaluating hypotension that developed after spinal anaesthesia in patients who were spontaneously breathing, pre-operatively hypovolemic, and were at an advanced age. METHODS: This observational study incl...

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Autores principales: Küpeli, İlke, Subaşı, Faruk, Eren, Nurhan, Arslan, Yusuf Kemal
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Turkish Anaesthesiology and Intensive Care Society 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279881/
https://www.ncbi.nlm.nih.gov/pubmed/32551448
http://dx.doi.org/10.5152/TJAR.2019.59251
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author Küpeli, İlke
Subaşı, Faruk
Eren, Nurhan
Arslan, Yusuf Kemal
author_facet Küpeli, İlke
Subaşı, Faruk
Eren, Nurhan
Arslan, Yusuf Kemal
author_sort Küpeli, İlke
collection PubMed
description OBJECTIVE: We aimed to test the efficacy of the pre-operative Pleth variability index (PVI) in evaluating hypotension that developed after spinal anaesthesia in patients who were spontaneously breathing, pre-operatively hypovolemic, and were at an advanced age. METHODS: This observational study included 94 patients aged >65 years with hip fracture. Demographic data, pre-operative heart rate, non-invasive arterial pressures, PVI values, and haemogram values were continuously measured following spinal anaesthesia. The measurements with and without hypotension were distinguished and their data were compared. RESULTS: The mean age of the patients was 77.4±8.2 years. In total, 56.4% of the patients developed hypotension after spinal anaesthesia, and hypotension was higher in women (p=0.037). Low pre-operative diastolic arterial pressures values were associated with the development of hypotension (p=0.037). The relationship between PVI and post-spinal hypotension was negative but significant (r=−0.239; p<0.05). Depending on the volume loss, an increase in the PVI (p<0.001) and its subsequent significant decrease after treatment in patients with hypotension (p<0.001) was observed. The correlation between noninvasively measured haemoglobin values and the values obtained from arterial blood gas samples was significant (p<0.001). CONCLUSION: This study showed that post-spinal hypotension may be associated with increased as well as decreased PVI values. However, these values cannot be clinically used for predicting pre-operative hypotension in hypovolemic patients.
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spelling pubmed-72798812020-06-17 Evaluating the Relationship between the Pleth Variability Index and Hypotension and Assessing the Fluid Response in Geriatric Hip Fracture under Spinal Anaesthesia: An Observational Study Küpeli, İlke Subaşı, Faruk Eren, Nurhan Arslan, Yusuf Kemal Turk J Anaesthesiol Reanim Original Article OBJECTIVE: We aimed to test the efficacy of the pre-operative Pleth variability index (PVI) in evaluating hypotension that developed after spinal anaesthesia in patients who were spontaneously breathing, pre-operatively hypovolemic, and were at an advanced age. METHODS: This observational study included 94 patients aged >65 years with hip fracture. Demographic data, pre-operative heart rate, non-invasive arterial pressures, PVI values, and haemogram values were continuously measured following spinal anaesthesia. The measurements with and without hypotension were distinguished and their data were compared. RESULTS: The mean age of the patients was 77.4±8.2 years. In total, 56.4% of the patients developed hypotension after spinal anaesthesia, and hypotension was higher in women (p=0.037). Low pre-operative diastolic arterial pressures values were associated with the development of hypotension (p=0.037). The relationship between PVI and post-spinal hypotension was negative but significant (r=−0.239; p<0.05). Depending on the volume loss, an increase in the PVI (p<0.001) and its subsequent significant decrease after treatment in patients with hypotension (p<0.001) was observed. The correlation between noninvasively measured haemoglobin values and the values obtained from arterial blood gas samples was significant (p<0.001). CONCLUSION: This study showed that post-spinal hypotension may be associated with increased as well as decreased PVI values. However, these values cannot be clinically used for predicting pre-operative hypotension in hypovolemic patients. Turkish Anaesthesiology and Intensive Care Society 2020-06 2019-10-17 /pmc/articles/PMC7279881/ /pubmed/32551448 http://dx.doi.org/10.5152/TJAR.2019.59251 Text en © Copyright 2020 by Turkish Anaesthesiology and Intensive Care Society This work is licensed under Creative Common Attribution-NonCommercial-NoDerivatives 4.0 International (CC BY-NC-ND 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) )
spellingShingle Original Article
Küpeli, İlke
Subaşı, Faruk
Eren, Nurhan
Arslan, Yusuf Kemal
Evaluating the Relationship between the Pleth Variability Index and Hypotension and Assessing the Fluid Response in Geriatric Hip Fracture under Spinal Anaesthesia: An Observational Study
title Evaluating the Relationship between the Pleth Variability Index and Hypotension and Assessing the Fluid Response in Geriatric Hip Fracture under Spinal Anaesthesia: An Observational Study
title_full Evaluating the Relationship between the Pleth Variability Index and Hypotension and Assessing the Fluid Response in Geriatric Hip Fracture under Spinal Anaesthesia: An Observational Study
title_fullStr Evaluating the Relationship between the Pleth Variability Index and Hypotension and Assessing the Fluid Response in Geriatric Hip Fracture under Spinal Anaesthesia: An Observational Study
title_full_unstemmed Evaluating the Relationship between the Pleth Variability Index and Hypotension and Assessing the Fluid Response in Geriatric Hip Fracture under Spinal Anaesthesia: An Observational Study
title_short Evaluating the Relationship between the Pleth Variability Index and Hypotension and Assessing the Fluid Response in Geriatric Hip Fracture under Spinal Anaesthesia: An Observational Study
title_sort evaluating the relationship between the pleth variability index and hypotension and assessing the fluid response in geriatric hip fracture under spinal anaesthesia: an observational study
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7279881/
https://www.ncbi.nlm.nih.gov/pubmed/32551448
http://dx.doi.org/10.5152/TJAR.2019.59251
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