Could Perfusion and Pleth Variability Index Be Useful in Managing Treatment and Morbidity in Patients with...

Background: This study aimed to investigate the potential benefits of the Perfusion Index (PI) and Pleth Variability Index (PVI), which indicate tissue microcirculatory perfusion, in the management of fluid therapy in patients with gastrointestinal (GI) bleeding, as well as their relationship with laboratory parameters. Methods: PI, PVI, and oxygen saturation values were measured using a Masimo pulse oximeter, along with routine tests, in patients with overt gastrointestinal bleeding presenting with melena, hematemesis, or hematochezia. These values were reassessed in patients who received treatment and fluid replacement prior to discharge. Baseline and discharge values were compared. The study examined whether there was a significant change in these values following treatment. The relationship between PI and PVI values and demographic findings, oxygen saturation, urea, creatinine, hematocrit, hemoglobin, and white blood cell counts were evaluated. Results: A total of 100 patients were included in the study, 55 (55%) of whom were male and 45 (45%) female, with a mean age of 65.8 ± 8.3 years. Of the patients, 81 had upper GI bleeding, and 19 had lower GI bleeding. Of the upper GI bleeds, 6 were esophageal variceal bleeds, and 75 were due to other causes. Perfusion index (PI) and plethysmographic variability index (PVI) measurements were obtained at initial admission and prior to discharge. The discharge PI value increased significantly compared with the admission PI value, whereas the discharge PVI value decreased significantly compared with the admission PVI value. PVI value. (p < 0.001) The relationship between PI and PVI values and other variables was analyzed using Spearman's correlation analysis. A significant negative correlation was found between PI-admission and PVI-admission, and between PI-discharge and PVI-discharge. (p < 0.001). Additionally, a significant but mild positive correlation was observed between PVI-out and age, creatinine, and urea. (p < 0.010, p < 0.030) Our results demonstrated a significant difference between PI-in and PI-out values following fluid replacement therapy. PVI-in and PVI-out values also differed significantly. There was a significant negative correlation between PI and PVI values. These findings suggest that the effectiveness of fluid replacement therapy can be monitored using PI and PVI. Conclusions: Monitoring fluid therapy in cases of gastrointestinal bleeding using the Massimo pulse oximeter is a simple, inexpensive, repeatable, noninvasive, feasible and appropriate method. Our study has significantly demonstrated that fluid replacement leads to an increase in PI values and a decrease in PVI values.