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Pleth variability index during preoxygenation could predict anesthesia-induced hypotension: A prospective,
Yoon Jung Kim1, Jeong-Hwa Seo1, Hyung-Chul Lee1
1Department of Anesthesiology and Pain Medicine, Seoul National University Hospital, Seoul National University College of Medicine, 101, Daehak-ro, Jongno-gu, 03080 Seoul, South Korea.
Journal of Clinical Anesthesia
|August 28, 2023
Summary
Changes in the pleth variability index (PVi) during preoxygenation can predict anesthesia-induced hypotension. A significant drop in %PVi indicates a higher risk of hypotension, aiding in proactive patient management.
Area of Science:
- Anesthesiology
- Cardiovascular Physiology
- Medical Technology
Background:
- Anesthesia-induced hypotension is a common complication during general anesthesia induction.
- Predictive markers for hypotension are crucial for improving patient outcomes and anesthetic management.
Purpose of the Study:
- To investigate if changes in the pleth variability index (PVi) during preoxygenation with forced ventilation can predict the occurrence of anesthesia-induced hypotension.
- To establish the predictive value of PVi variations for hypotension following anesthetic administration.
Main Methods:
- A prospective, observational study was conducted with 96 patients undergoing general anesthesia.
- The pleth variability index (PVi) was measured before and after 1 minute of preoxygenation with forced ventilation.
- Anesthesia-induced hypotension was defined as mean arterial pressure <60 mmHg within 15 minutes of anesthetic infusion.
Main Results:
- Anesthesia-induced hypotension occurred in 35.6% of the 87 analyzed patients.
- A percentage change in PVi (%PVi) of -7.6% or less was identified as a significant predictor of hypotension (AUC = 0.711, P < 0.001).
- A low %PVi was a significant determinant of anesthesia-induced hypotension, with an odds ratio of 9.856 (P < 0.001).
Conclusions:
- The percentage change in PVi during preoxygenation with deep breathing is a valuable tool for predicting anesthesia-induced hypotension.
- Monitoring PVi variations offers a non-invasive method to identify patients at risk for hypotension during anesthetic induction.
- These findings support the integration of PVi monitoring into routine anesthetic procedures for enhanced patient safety.
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