This article is part of the supplement: 29th International Symposium on Intensive Care and Emergency Medicine
Does the pleth variability index improve fluid management during major abdominal surgery?
St-Luc Hospital, Université Catholique de Louvain, Brussels, Belgium
Critical Care 2009, 13(Suppl 1):P204 doi:10.1186/cc7368
The electronic version of this article is the complete one and can be found online at: http://ccforum.com/content/13/S1/P204
| Published: | 13 March 2009 |
© 2009 Forget et al; licensee BioMed Central Ltd.
Introduction
Dynamic parameters predict fluid responsiveness and improve fluid management during surgery. We intend to demonstrate that the noninvasive pleth variability index (PVI) guides peroperative fluid management and optimizes the circulatory status.
Methods
Patients scheduled for major abdominal surgery were randomized into two groups comparing the peroperative PVI-directed fluid management (group P) versus standard care (control, group C). Protocol: induction of general anesthesia was followed by, in group P, 500 ml followed by 2 ml/kg/hour crystalloids; 250 ml colloids infused if PVI >13% for more than 5 minutes; if required, vasoactive support was introduced after lowering PVI <10%. In group C, 500 ml crystalloids followed by fluids at the discretion of the anesthesiologist.
Results
Eighty-two patients completed the protocol. No difference was detected in preoperative characteristics, type of surgery and anesthesia. Peroperative and postoperative (24-hour) crystalloid infusions were significantly different. Lactate levels were significantly lower in group P, whereas the peroperative and postoperative volumes infused in group P were lower (Figure 1).
Figure 1.Conclusion
Tzhe PVI improves peroperative fluid management in abdominal surgery. The reduced mean volume infused associated with reduced lactate levels suggests the capacity of the PVI to infer tailored fluid administration.