Accuracy of the pleth variability index to predict fluid responsiveness depends on the perfusion index

Abstract

The PVI was not able to predict fluid responsiveness with sufficient accuracy. In patients with higher perfusion states, the PVI improved its ability to predict haemodynamic changes, strongly suggesting a relevant influence of the PI on the PVI.

Perfusion index and plethysmographic variability index in patients with interscalene nerve catheters

“…The site of measurement has an influence, 7 and PVI values also depend on PI values. 8,16 The present study confirms these findings; however, regardless of nerve blockade and vasomotor state, the application of a fluid bolus is reflected by a decrease in PVI values in both limbs.…”

“…It is possible that the application of local anesthetics might result in changes in the state of peripheral perfusion, which could influence the accuracy of PVI to predict changes in preload reliably following volume expansion. 8 …”

Does pneumoperitoneum affect perfusion index and pleth variability index in patients receiving combined epidural and general anesthesia?

“…We have asserted that SVV values must be estimated cautiously during pneumoperitoneum (6). Pleth variability index (PVI) is another dynamic index, and many studies concluded that it is useful for the assessment of fluid responsiveness in patients (2,(7)(8)(9) although one study concluded that PVI seems inaccurate to predict fluid responsiveness after conventional…”

Inter-device differences in monitoring for goal-directed fluid therapy

“…[86][87][88][89][90] The reasons for this paradox (excellent predictor of fluid responsiveness yet not in agreement with arterial-derived metrics) are not clear but may be related to the dependence of PVI on perfusion. 91 While the Masimo device may not be as effective as its more invasive counterparts during periods of malperfusion, it has three major advantages -relative low cost in comparison with its competitors, the ubiquity of pulse oximetry (which of course is a Canadian Anesthesiologists' Society basic monitoring standard), 92 and ease of use.…”