Correlation coefficient between plethysmographic variability index and Systolic Pressure Variation as an indicator for fluid responsiveness in hypotensive patients in the ICU/OT.
Med J Armed Forces India
; 80(1): 52-59, 2024.
Article
em En
| MEDLINE
| ID: mdl-38261854
ABSTRACT
Background:
Prediction of fluid responsiveness in hypotensive patients is a challenge. The correlation between a novel noninvasive dynamic indicator, Pleth Variability Index (PVI ®), and a gold-standard Systolic Pressure Variation (SPV) as a measure of fluid responsiveness was assessed in the Intensive Care Unit (ICU) or Operation Theatre (OT) in a tertiary care hospital.Methods:
A prospective experimental study was conducted over a span of one year on 100 mechanically ventilated patients with hypotension. Vital parameters along with SPV and PVI ® were recorded before and after a standard volume expansion protocol. A 10% SPV threshold was used to define fluid responders and nonresponders.Results:
Pearson's correlation graph at baseline showed positive correlation between PVI ® and SPV (r = 0.59, p-value = 0.001). Strength of correlation was comparatively less but still showed positive correlation at 15 (r = 0.39, p-value = 0.009) and 30 (r = 0.404, p-value = 0.004) minutes of fluid bolus. The Bland Altman analysis of baseline values of PVI ® and SPV showed good agreement with a mean bias of 9.05. Percentage change of PVI ® and SPV over 30 min showed a statistically significant positive correlation in the responder group (r = 0.53, p < 0.05). A threshold value of PVI ® more than 18% before volume expansion differentiated fluid responders and nonresponders with a sensitivity of 75% and specificity of 67%, with an area under Receiver Operating Characteristic (ROC) of 0.78.Conclusion:
A positive correlation exists between SPV and PVI ®, justifying the use of noninvasive PVI ® in a clinical setting of hypotension.
Texto completo:
1
Coleções:
01-internacional
Base de dados:
MEDLINE
Tipo de estudo:
Guideline
/
Prognostic_studies
Idioma:
En
Revista:
Med J Armed Forces India
Ano de publicação:
2024
Tipo de documento:
Article
País de afiliação:
Índia