Pleth variability index may predict preload responsiveness in patients treated with nasal high flow: a physiological study
The purpose of this study was to determine whether the plethysmographic variability index (PVi) can predict preload responsiveness in nasal high flow (NHF) patients (≥30 L/min) with any sign of hypoperfusion. Preload responsiveness was defined as a ≥10% increase in stroke volume (SV), measured by tr...
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| Veröffentlicht in: | Journal of applied physiology (1985) 2021-06, Vol.130 (6), p.1660-1667 |
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| container_title | Journal of applied physiology (1985) |
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| creator | García de Acilu, Marina Pacheco, Andrés Santafé, Manel Ramos, Francisco-Javier Ruiz-Rodríguez, Juan C Ferrer, Ricard Roca, Oriol |
| description | The purpose of this study was to determine whether the plethysmographic variability index (PVi) can predict preload responsiveness in nasal high flow (NHF) patients (≥30 L/min) with any sign of hypoperfusion. Preload responsiveness was defined as a ≥10% increase in stroke volume (SV), measured by transthoracic echocardiography, after passive leg raising. SV and PVi were reassessed in preload responders after receiving a 250-mL fluid challenge. Twenty patients were included, and 12 patients (60%) were preload responders. Responders showed higher baseline mean PVi (24% vs. 13%; p=0.001) and higher mean PVi variation (∆PVi) after passive leg raising (6.8% vs. -1.7%; p |
| doi_str_mv | 10.1152/japplphysiol.00614.2020 |
| format | Article |
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Preload responsiveness was defined as a ≥10% increase in stroke volume (SV), measured by transthoracic echocardiography, after passive leg raising. SV and PVi were reassessed in preload responders after receiving a 250-mL fluid challenge. Twenty patients were included, and 12 patients (60%) were preload responders. Responders showed higher baseline mean PVi (24% vs. 13%; p=0.001) and higher mean PVi variation (∆PVi) after passive leg raising (6.8% vs. -1.7%; p<0.001). No differences between mean ∆PVi after passive leg raising and mean ∆PVi after fluid challenge were observed (6.8 % vs. 7.4%; p=0.24), and both values were strongly correlated (r=0.84; p<0.001). Baseline PVi and ∆PVi after passive leg raising showed excellent diagnostic accuracy identifying preload responders (AUROC 0.92 and 1.00, respectively). Baseline PVi ≥16% had a sensitivity of 91.7% and a specificity of 87.5% for detecting preload responders. Similarly, ∆PVi after passive leg raising ≥2%, had a 100% of both sensitivity and specificity. Thus, PVi might predict preload responsiveness in patients treated with NHF, suggesting that it may guide fluid administration in these patients.</description><identifier>ISSN: 8750-7587</identifier><identifier>EISSN: 1522-1601</identifier><identifier>DOI: 10.1152/japplphysiol.00614.2020</identifier><identifier>PMID: 33856256</identifier><language>eng</language><publisher>United States: American Physiological Society</publisher><subject>Echocardiography ; High flow ; Leg ; Sensitivity ; Stroke ; Stroke volume ; Variability</subject><ispartof>Journal of applied physiology (1985), 2021-06, Vol.130 (6), p.1660-1667</ispartof><rights>Copyright American Physiological Society Jun 2021</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><cites>FETCH-LOGICAL-c287t-3107890df31032e9622117d7fa7fb16b0418efa68668f6ed56bb612e3952d253</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,780,784,3039,27924,27925</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33856256$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>García de Acilu, Marina</creatorcontrib><creatorcontrib>Pacheco, Andrés</creatorcontrib><creatorcontrib>Santafé, Manel</creatorcontrib><creatorcontrib>Ramos, Francisco-Javier</creatorcontrib><creatorcontrib>Ruiz-Rodríguez, Juan C</creatorcontrib><creatorcontrib>Ferrer, Ricard</creatorcontrib><creatorcontrib>Roca, Oriol</creatorcontrib><title>Pleth variability index may predict preload responsiveness in patients treated with nasal high flow: a physiological study</title><title>Journal of applied physiology (1985)</title><addtitle>J Appl Physiol (1985)</addtitle><description>The purpose of this study was to determine whether the plethysmographic variability index (PVi) can predict preload responsiveness in nasal high flow (NHF) patients (≥30 L/min) with any sign of hypoperfusion. Preload responsiveness was defined as a ≥10% increase in stroke volume (SV), measured by transthoracic echocardiography, after passive leg raising. SV and PVi were reassessed in preload responders after receiving a 250-mL fluid challenge. Twenty patients were included, and 12 patients (60%) were preload responders. Responders showed higher baseline mean PVi (24% vs. 13%; p=0.001) and higher mean PVi variation (∆PVi) after passive leg raising (6.8% vs. -1.7%; p<0.001). No differences between mean ∆PVi after passive leg raising and mean ∆PVi after fluid challenge were observed (6.8 % vs. 7.4%; p=0.24), and both values were strongly correlated (r=0.84; p<0.001). Baseline PVi and ∆PVi after passive leg raising showed excellent diagnostic accuracy identifying preload responders (AUROC 0.92 and 1.00, respectively). Baseline PVi ≥16% had a sensitivity of 91.7% and a specificity of 87.5% for detecting preload responders. Similarly, ∆PVi after passive leg raising ≥2%, had a 100% of both sensitivity and specificity. Thus, PVi might predict preload responsiveness in patients treated with NHF, suggesting that it may guide fluid administration in these patients.</description><subject>Echocardiography</subject><subject>High flow</subject><subject>Leg</subject><subject>Sensitivity</subject><subject>Stroke</subject><subject>Stroke volume</subject><subject>Variability</subject><issn>8750-7587</issn><issn>1522-1601</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><recordid>eNpdkU1v1DAQhi1URLeFvwCWeuGSxd_29oYqaJEqwaH3yIknXa-8cWo7LeHX420XhDjNSPO8r0Z6EPpAyZpSyT7t7DSFabtkH8OaEEXFmhFGXqFVvbKGKkJP0MpoSRotjT5FZznvCKFCSPoGnXJupGJSrdCvHwHKFj_a5G3ngy8L9qODn3hvFzwlcL4vhxmidThBnuKY_SOMkHMF8WSLh7FkXBLYAg4_-do22mwD3vr7LR5CfLrEFh9_jfe-r6dcZre8Ra8HGzK8O85zdPf1y93VTXP7_frb1efbpmdGl4ZTos2GuKEunMFGMUapdnqweuio6oigBgarjFJmUOCk6jpFGfCNZI5Jfo4-vtROKT7MkEu797mHEOwIcc4tk5QzIbgyFb34D93FOY31uUoJpUStFJXSL1SfYs4JhnZKfm_T0lLSHuy0_9ppn-20Bzs1-f7YP3d7cH9zf3Tw3wjikIs</recordid><startdate>20210601</startdate><enddate>20210601</enddate><creator>García de Acilu, Marina</creator><creator>Pacheco, Andrés</creator><creator>Santafé, Manel</creator><creator>Ramos, Francisco-Javier</creator><creator>Ruiz-Rodríguez, Juan C</creator><creator>Ferrer, Ricard</creator><creator>Roca, Oriol</creator><general>American Physiological Society</general><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7QP</scope><scope>7QR</scope><scope>7TK</scope><scope>7TS</scope><scope>7U7</scope><scope>8FD</scope><scope>C1K</scope><scope>FR3</scope><scope>P64</scope><scope>7X8</scope></search><sort><creationdate>20210601</creationdate><title>Pleth variability index may predict preload responsiveness in patients treated with nasal high flow: a physiological study</title><author>García de Acilu, Marina ; Pacheco, Andrés ; Santafé, Manel ; Ramos, Francisco-Javier ; Ruiz-Rodríguez, Juan C ; Ferrer, Ricard ; Roca, Oriol</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c287t-3107890df31032e9622117d7fa7fb16b0418efa68668f6ed56bb612e3952d253</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Echocardiography</topic><topic>High flow</topic><topic>Leg</topic><topic>Sensitivity</topic><topic>Stroke</topic><topic>Stroke volume</topic><topic>Variability</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>García de Acilu, Marina</creatorcontrib><creatorcontrib>Pacheco, Andrés</creatorcontrib><creatorcontrib>Santafé, Manel</creatorcontrib><creatorcontrib>Ramos, Francisco-Javier</creatorcontrib><creatorcontrib>Ruiz-Rodríguez, Juan C</creatorcontrib><creatorcontrib>Ferrer, Ricard</creatorcontrib><creatorcontrib>Roca, Oriol</creatorcontrib><collection>PubMed</collection><collection>CrossRef</collection><collection>Calcium & Calcified Tissue Abstracts</collection><collection>Chemoreception Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>Physical Education Index</collection><collection>Toxicology Abstracts</collection><collection>Technology Research Database</collection><collection>Environmental Sciences and Pollution Management</collection><collection>Engineering Research Database</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of applied physiology (1985)</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>García de Acilu, Marina</au><au>Pacheco, Andrés</au><au>Santafé, Manel</au><au>Ramos, Francisco-Javier</au><au>Ruiz-Rodríguez, Juan C</au><au>Ferrer, Ricard</au><au>Roca, Oriol</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Pleth variability index may predict preload responsiveness in patients treated with nasal high flow: a physiological study</atitle><jtitle>Journal of applied physiology (1985)</jtitle><addtitle>J Appl Physiol (1985)</addtitle><date>2021-06-01</date><risdate>2021</risdate><volume>130</volume><issue>6</issue><spage>1660</spage><epage>1667</epage><pages>1660-1667</pages><issn>8750-7587</issn><eissn>1522-1601</eissn><abstract>The purpose of this study was to determine whether the plethysmographic variability index (PVi) can predict preload responsiveness in nasal high flow (NHF) patients (≥30 L/min) with any sign of hypoperfusion. Preload responsiveness was defined as a ≥10% increase in stroke volume (SV), measured by transthoracic echocardiography, after passive leg raising. SV and PVi were reassessed in preload responders after receiving a 250-mL fluid challenge. Twenty patients were included, and 12 patients (60%) were preload responders. Responders showed higher baseline mean PVi (24% vs. 13%; p=0.001) and higher mean PVi variation (∆PVi) after passive leg raising (6.8% vs. -1.7%; p<0.001). No differences between mean ∆PVi after passive leg raising and mean ∆PVi after fluid challenge were observed (6.8 % vs. 7.4%; p=0.24), and both values were strongly correlated (r=0.84; p<0.001). Baseline PVi and ∆PVi after passive leg raising showed excellent diagnostic accuracy identifying preload responders (AUROC 0.92 and 1.00, respectively). Baseline PVi ≥16% had a sensitivity of 91.7% and a specificity of 87.5% for detecting preload responders. Similarly, ∆PVi after passive leg raising ≥2%, had a 100% of both sensitivity and specificity. Thus, PVi might predict preload responsiveness in patients treated with NHF, suggesting that it may guide fluid administration in these patients.</abstract><cop>United States</cop><pub>American Physiological Society</pub><pmid>33856256</pmid><doi>10.1152/japplphysiol.00614.2020</doi><tpages>8</tpages></addata></record> |
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| subjects | Echocardiography High flow Leg Sensitivity Stroke Stroke volume Variability |
| title | Pleth variability index may predict preload responsiveness in patients treated with nasal high flow: a physiological study |
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