Does the Pleth Variability Index Indicate the Respiratory-Induced Variation in the Plethysmogram and Arterial Pressure Waveforms?

• DOI: 10.1213/ane.0b013e318167ab1f
• Publication Date: 2009-03-05T17:04:53Z
• Authors: Maxime Cannesson; Bertrand Delannoy; Antoine Morand; Pascal Rosamel; Yassin Attof; Olivier Bastien; Jean-Jacques Lehot
• Keywords: Plethysmograph; Photoplethysmogram; Preload

In Brief BACKGROUND: Respiratory variations in the pulse oximeter plethysmographic waveform amplitude (ΔPOP) are sensitive to changes preload and can predict fluid responsiveness mechanically ventilated patients. However, they cannot be easily calculated from a bedside monitor. Pleth variability index (PVI, Masimo Corp., Irvine, CA) is new algorithm that automatically calculates ΔPOP. The aim of our study was test ability this device continuously monitor METHODS: Twenty-five patients were studied after induction general anesthesia. PVI respiratory plethysmography (perfusion index). Data (mean arterial blood pressure, central venous ΔPOP, PVI) recorded at baseline anti-Trendelenburg position and, finally, Trendelenburg position. RESULTS: There significant relationship between ΔPOP (r = 0.92; P < 0.05). Over 75 measurements, 42 (56%) presented value >13%. A threshold 11.5% able discriminate >13% ≤13% with sensitivity 93% specificity 97%. Area under curve for 0.990 ± 0.07. CONCLUSION: This first demonstrate PVI, an derived analysis, has potential clinical applications noninvasive monitoring. IMPLICATIONS: pleth (Masimo automated method calculating respiratory-induced variation plethysmogram follows similar pressure.