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Pleth Variability Index-Based Goal-Directed Fluid Management in Patients Undergoing Elective Gynecologic Surgery
Gulseren Yilmaz1, Aysu Akca2, Huseyin Kiyak2
1Department of Anesthesiology and Reanimation, University of Health Sciences Turkey, Faculty of Medicine, Kanuni Sultan Suleyman Hospital, Istanbul, Turkey.
Sisli Etfal Hastanesi Tip Bulteni
|August 22, 2022
Summary
Pleth variability index (PVI)-based goal-directed fluid management (GDFM) improves hemodynamic stability and reduces lactate levels during gynecologic surgery compared to conventional fluid management (CFM). This approach enhances patient outcomes in surgical settings.
Area of Science:
- Anesthesiology
- Surgical Fluid Management
- Hemodynamic Monitoring
Background:
- Limited data exists on the efficacy of PVI-based GDFM in gynecologic surgery.
- Intraoperative fluid management impacts surgical outcomes.
Purpose of the Study:
- To compare PVI-based GDFM with CFM in gynecologic surgery.
- To assess the impact on intraoperative hemodynamics and lactate levels.
Main Methods:
- Randomized controlled trial with 70 patients undergoing elective gynecologic surgery.
- Patients were assigned to either CFM or PVI-based GDFM.
- Hemodynamic data, arterial blood gas analysis, and fluid volumes were recorded hourly.
Main Results:
- CFM group received significantly more fluids than the GDFM group (p<0.001).
- Mean arterial pressure was lower in the CFM group at 2 hours (p=0.047).
- Lactate levels increased significantly in the CFM group but remained stable in the GDFM group.
Conclusions:
- PVI-based GDFM enhances intraoperative hemodynamic stability in gynecologic surgery.
- PVI-based GDFM leads to lower intraoperative lactate levels compared to CFM.
- This fluid management strategy improves patient outcomes during gynecologic procedures.
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