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CC BY-NC-ND 4.0 · J Neuroanaesth Crit Care 2019; 06(01): S06
DOI: 10.1055/s-0039-1684119
Abstracts
Indian Society of Neuroanaesthesiology and Critical Care

A0012 Pleth Variability Index versus Stroke Volume Variation as Predictors of Fluid Responsiveness in Prone Position

Bhagya R. Jena
1   Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India
,
Girija P. Rath
1   Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India
,
Vikas Chouhan
1   Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India
,
Nidhi Gupta
2   Indraprastha Apollo Hospital, New Delhi, India
,
Siddharth Chavali
1   Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India
,
Arvind Chaturvedi
1   Department of Neuroanaesthesiology and Critical Care, All India Institute of Medical Sciences, New Delhi, India
› Author Affiliations
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Publication History

Publication Date:
12 March 2019 (online)

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    Background: Prone position is commonly used for spine surgery. This study was designed to investigate the effects of prone position on the accuracy of pleth variability index (PVI) to predict fluid responsiveness and to correlate the changes in stroke volume variation (SVV) with PVI in prone position.

    Materials and Methods: After Institutional Ethics Committee approval, 51 adults of either gender, aged 18–65 years, ASA status I-II, undergoing elective spine surgery in prone position were included. Heart rate, blood pressure, cardiac output, stroke volume index (SVI), SVV, CI, perfusion index (PI), and PVI were recorded before and after volume expansion with 500 mL of hetastarch 6% given twice; in supine and after prone position. A Masimo pulse oximeter probe with a Radical-7 monitor and a Vigileo monitor with an interface FloTrac transducer were used where appropriate. The above parameters were recorded at different time intervals.

    Results: Mean age was 41 years; most were male patients (M33:F18). After second volume expansion, SVI was increased by 9.2%, SVV was reduced by 2.3% (p = 0.00), and PVI was decreased by 38.1% (p = 0.00), compared with the previous values. In supine position, there was no significant difference between the area under ROC curve for SVV (0.745) and PVI (0.611) with respect to identifying a change in SVI greater than 15%. The best threshold values to predict fluid responsiveness in supine position were more than 12% for SVV and PVI. Similarly, in prone position, there was no significant difference between the area under the ROC curve for SVV (0.638) and PVI (0.532). The best threshold values to predict fluid responsiveness were more than 9% for SVV and 11% for PVI.

    Conclusions: Both SVV and PVI are useful indicators of fluid responsiveness in mechanically ventilated patients undergoing spine surgery. SVV and PVI correlated well, in prone position, with regard to fluid responsiveness.


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