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Related Experiment Video

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Evaluation of Fluid Overload by Bioelectrical Impedance Vectorial Analysis
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Pleth variability index and fluid management practices: a multicenter service evaluation.

Patrice Forget1, Simon Lacroix2, Eric P Deflandre2,3,4,5

  • 1Institute of Applied Health Sciences, Epidemiology group, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, NHS Grampian, Department of Anaesthesia, Aberdeen, UK. forgetpatrice@yahoo.fr.

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Introducing the Pleth Variability Index (PVI) did not change fluid volumes during surgery. Effective implementation strategies are needed to alter clinical practices with new technologies.

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Area of Science:

  • Anesthesiology
  • Critical Care Medicine
  • Surgical Innovation

Background:

  • New technologies can alter clinical practices, particularly if user-friendly and non-invasive.
  • Fluid management during surgery is a critical aspect of patient care.
  • The Pleth Variability Index (PVI) is a non-invasive tool for monitoring fluid responsiveness.

Purpose of the Study:

  • To evaluate changes in fluid management practices and clinical outcomes before and after introducing PVI.
  • To assess the impact of a new non-invasive technology on surgical fluid administration.

Main Methods:

  • An observational, before-and-after, multicenter service evaluation.
  • Inclusion of 88 surgical procedures across five centers over two years.
  • Comparison of fluid volumes infused and clinical outcomes pre- and post-PVI implementation.

Main Results:

  • Median intraoperative fluid volumes remained similar (1000 ml) before and after PVI introduction.
  • No significant changes in fluid management practices were detected.
  • Clinical outcomes were comparable between the pre- and post-PVI periods.

Conclusions:

  • The introduction of PVI alone did not alter fluid management practices in low-to-moderate risk surgery.
  • Implementation strategies are crucial for integrating new technologies and changing clinical practice.
  • Further research may be needed to optimize the use of PVI in surgical settings.