Pleth variability index to predict fluid responsiveness in colorectal surgery

Area of Science:

• Anesthesiology
• Critical Care Medicine
• Surgical Oncology

Background:

• Goal-directed fluid therapy is crucial for reducing postoperative morbidity in major abdominal surgery.
• The Pleth Variability Index (PVI), derived from pulse oximetry, shows promise in predicting fluid responsiveness.
• This study investigates PVI's utility in low-risk colorectal surgery, guided by esophageal Doppler.

Purpose of the Study:

• To determine if PVI can predict fluid responsiveness in low-risk colorectal surgery patients.
• To compare PVI's predictive ability with esophageal Doppler stroke volume measurements.
• To evaluate PVI's effectiveness in both steady-state and dynamic intraoperative conditions.

Main Methods:

• Twenty-five low-risk patients undergoing colorectal resection were studied.
• PVI and stroke volume were measured at baseline and after fluid boluses.
• Patients were classified as responders or non-responders based on stroke volume increase.

Main Results:

• Baseline PVI at the finger was higher in fluid responders.
• PVI at the finger and earlobe predicted stroke volume increases in steady-state conditions (AUCs 0.96 and 0.98, respectively).
• Intraoperative PVI at the finger predicted fluid responsiveness (AUC 0.71), while earlobe PVI did not.

Conclusions:

• Finger PVI demonstrates predictive ability for fluid responsiveness in ventilated colorectal surgery patients.
• PVI measured at the finger may be a valuable tool for guiding fluid therapy during surgery.
• Further research could explore PVI's role in diverse surgical populations.