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Pulse oximeter plethysmograph variation and its relationship to the arterial waveform in mechanically ventilated

J R Chandler1, E Cooke, C Petersen

  • 1Department of Anesthesiology, Pharmacology and Therapeutics, The University of British Columbia, Vancouver, BC, Canada. drjrschandler@hotmail.com

Journal of Clinical Monitoring and Computing
|March 13, 2012
PubMed

Insights

Mechanically ventilated children

Area of Science:

  • Pediatric critical care medicine
  • Respiratory physiology
  • Medical monitoring technologies

Background:

  • Mechanical ventilation induces variations in arterial pulse pressure and plethysmograph waveforms.
  • These variations are established markers of volume responsiveness in adults.
  • Pediatric data on these indices are limited.

Purpose of the Study:

  • To assess the feasibility of recording plethysmograph indices in children.
  • To examine the relationship between pulse pressure variation (ΔPP), plethysmograph variation (ΔPOP), and plethysmograph variability index (PVI) in mechanically ventilated children.
  • To compare pediatric findings with adult data.

Main Methods:

  • Prospective, observational study of mechanically ventilated children (<11 years) with arterial catheters.
  • Real-time waveform and trend data recording.
  • Manual calculation of ΔPP and ΔPOP; comparison with PVI using Bland-Altman analysis and Pearson correlations.

Main Results:

  • Feasible recording of plethysmographic variability indices in 92% of subjects.
  • Strong correlation and close agreement between ΔPP and ΔPOP (r = 0.8439, Bias = 1.44 ± 6.4%).
  • PVI showed strong correlations with both ΔPP (r = 0.7049) and ΔPOP (r = 0.715).

Conclusions:

  • Obtaining plethysmographic variability indices is feasible in mechanically ventilated children under diverse physiological stresses.
  • These indices demonstrate strong correlations, similar to adult findings.
  • Supports the use of these non-invasive markers for assessing fluid responsiveness in pediatric patients.

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