Efficacy of Pleth Variability Index (PVI) to Evaluate Intraoperative Fluid Management During Orthopedic Spinal Surgery: A Randomized Controlled Trial
Objective: To prevent complications during major surgery, it is important to monitor blood and fluid treatment. The Pleth Variability İndex (PVI) allows noninvasive assessment of fluid management. It is based on respiratory changes in arterial pulse pressure. In our study, we aimed to compare the management in terms of variations in PVI in response to fluid loading in the monitorization of intraoperative fluid management in major surgery using classical calculation method and CVP Method: The patients were randomized into two equal (n=50) groups. In Group C, the required amount of fluid replacement was carried out with crystalloid solutions using the 4-2-1 rule and by calculating fasting, maintenance, and insensible losses. In the PVI group, 250 mL of crystalloid solution was administered in 5 minutes to patients with a PVI greater than 14%, patients with a PVI less than 14% were administered a fluid infusion with an initial dose of 4 mL kg-1 h-1. Results: In the comparison of intraoperative fluid management the amount of intraoperative fluid replacement was 3522±1098.1 mL in Group C and 1914±542.86 mL in Group PVI (p0.05). Conclusion: It has been thought that PVI assessment is more valuable than CVP monitoring because it is noninvasive and thus provides better cardiac stabilization with less fluid replacement. It can also provide more accurate results when evaluating intravascular volume status.
Ortopedik Spinal Cerrahi Olgularında İntraoperatif Sıvı Yönetimini Değerlendirmede Pleth Değişkenlik İndeksinin Etkinliği: Randomize Kontrollü Çalışma
Amaç: Majör cerrahilerde komplikasyonları önlemek için, kan ve sıvı tedavisini izlemek önemlidir. “Pleth Değişkenlik İndeksi” (PDİ) sıvı tedavisinin invaziv olmayan ölçümüne olanak sağlayan, temeli arteriyel nabız basıncındaki solunumsal değişikliklere dayanan bir yöntemdir. Çalışmamızda, majör cerrahide intraoperatif sıvı yönetiminin, klasik hesaplama yöntemi ve SVB ile takibinin, sıvı yüklemesine verilen PVI değişikliklerine göre yönetimin karşılaştırılması amaçlanmıştır. Yöntem: Hastalar randomize olarak 2 eşit gruba (n=50) ayrıldı. Grup C’de sıvı gereksinimi açlık, idame ve insensibl kayıp 4-2-1 kuralına göre hesaplanarak kristalloid ile karşılandı. Grup PDİ’de PDİ değeri 14’ün üstünde olan hastalara 250 mL kristalloid 5 dk’da gidecek şekilde verildi. PDİ değeri 14’ün altında olan hastalara 4 mL kg-1 sa-1 sıvı infüzyonu açıldı. Bulgular: Grupların intraoperatif sıvı yönetimlerinin karşılaştırmasında; Grup C’de intraoperatif verilen sıvı miktarı 3522±1098.1 mL ve Grup PDİ de intraoperatif verilen sıvı miktarı 1914±542.86 ml (p
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- ISSN: 1300-0578
- Yayın Aralığı: Yılda 4 Sayı
- Başlangıç: 1993
- Yayıncı: Betül Kartal
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