[A prospective clinical study of pleth variability index in prediction of volume responsiveness in patients with septic shock].

• DOI: 10.3760/cma.j.issn.2095-4352.2015.01.005
• Publication Date: 2015-01-01
• Authors: Nianfang Lu; Ruiqiang Zheng; Hua Lin; Jiangquan Yu; Jun Shao; Xiaoyan Wu; Haixia Wang
• Keywords: Cardiac index; Mean arterial pressure; Intravascular volume status; Pulse pressure

To evaluate the role of pleth variability index ( PVI ) by passive leg raising PLR test in volume responsiveness and status prediction patients with septic shock.A prospective randomized controlled trial RCT was conducted. Eighty-seven suffering from shock undergoing mechanical ventilation Department Critical Care Medicine Subei People's Hospital June 2012 to September 2014 were enrolled. The hemodynamic changes before after monitored pulse indicated continuous cardiac output PiCCO monitoring. Responsive group: positive fluid response defined as an increase CI )≥10% PLR. Unresponsive negative CI<10% parameters, including heart rate HR ), mean arterial pressure MAP central venous CVP stroke variation SVV PVI, parameters (ΔHR, ΔMAP, ΔCVP, ΔSVV, ΔCI, ΔPVI determined. relations between their ΔCI analyzed Pearson analysis. for evaluated receiver operating characteristic ROC curves.145 PLRs 87 conducted, 67 responsive group 78 unresponsive group. There no statistically significant differences HR, MAP, groups. significantly higher than those [ SVV: 16.9±3.1 )% vs. 8.4±2.2 %, t = 9.078, P 0.031; PVI: 20.6±4.3 11.1±3.2 )%, 19.189, 0.022 ]. CVP, SVV, that mL×s(-1)×m(-2): 78.3±6.7 60.0±8.3, 2.902, 0.025 ). ΔHR, ΔCVP ΔSVV: 4.6±1.5 1.8±0.9 11.187, 0.022; mL×s(-1)×m(-2) ): 18.3±1.7 1.7±0.5, 3.696, 0.014; ΔPVI: 6.4±1.1 1.3±0.2 19.563, 0.013 No correlation or found. r 0.850, 0.015 0.867, 0.001 correlated ΔCI. It shown curve area under AUC 0.948, cut-off 12.4%, sensitivity 85.4%, specificity 86.6%. 0.957, 14.8%, 87.5%, 84.8%. other ).PVI can better predict mechanically ventilating a new continuous, noninvasive functional parameter has same accuracy SVV.