Can a measurement called pleth variability index (PVI) be used to guide clinicians in administrating fluids to patients undergoing general anaesthesia?

Does pleth variability index predict fluid responsiveness in mechanically ventilated patients during general anaesthesia for non-cardiac surgery?

Status

Completed

Phases

Unknown

Study type

Observational

Source

ANZCTR

Registry ID

ACTRN12611000340932

Acronym

PVI Fluid Responsiveness

Enrollment

Registered

2011-03-31

Start date

2010-09-03

Completion date

2012-12-21

Last updated

2020-01-13

For informational purposes only — not medical advice. Sourced from public registries and may not reflect the latest updates. Terms

Conditions

None listed

Brief summary

Aim: The aim of this project is to investigate whether pleth variability index (PVI), derived from the Masimo Rainbow (Registered Trademark) SET Pulse CO-Oximetry, can predict fluid responsiveness in mechanically ventilated patients during general anaesthesia for non-cardiac surgery. Significance: The significance of assessing PVI is that it is completely non-invasive (it only requires a probe on the finger), it provides a dynamic indicator of fluid responsiveness, and the PVI is displayed as a continuously monitored number, which makes it simple and user-friendly. Hypothesis: The main hypothesis is that PVI can accurately and consistently predict fluid responsiveness in mechanically ventilated patients during general anaesthesia following a standard fluid challenge. Objective: The main objective is to assess the accuracy and consistency of PVI as an indicator of assessing fluid responsiveness, when measured against the more well-established oesophageal Doppler/fluid challenge method. This will determine whether PVI can be used reliably as an indicator of fluid responsiveness. Methods: In this observational study, a total of 30 participants will be assessed as being fluid responsive or fluid non-responsive according to stroke volume changes (measured via the minimally invasive oesophageal Doppler monitor) following the administration of a standard fluid challenge. The two main measurements including PVI and stroke volume index will be recorded along with other variables. Using appropriate statistical analysis, we will determine the consistency and accuracy of PVI in detecting fluid responsiveness. Likely benefit of the research: The significance of assessing PVI in the current study is that it may provide a non-invasive and continuous way of determining which patients are likely to respond and thus benefit from fluid therapy, a measurement that previously requires much more invasive techniques.

Interventions

Pleth variability index (PVI) is measured before and after volume expansion with 500 mL of intravenous colloid. The measurements are done before induction of general anaesthesia when a patient presents for their surgery.

Eligibility

Sex/Gender

All

Age

0 to No maximum

Healthy volunteers

Inclusion criteria

Non-cardiac surgical patients requiring general anaesthesia, tracheal intubation and mechanical ventilation

Exclusion criteria

Patients with arrhythmia (including atrial fibrillation), ischaemic heart disease, cardiac failure (including left and right ventricular dysfunctions), and any contraindications to oesophageal probe insertion (e.g. oesophageal varices)

Outcome results