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Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients

Year 2022, Volume 7, Issue 1, 15 - 20, 28.03.2022
https://doi.org/10.25000/acem.1080760

Abstract

BACKGROUND: This study was designed to determine the effects of PVI-guided monitoring on the optimal intravascular volume replacement during hip and knee arthroplasty in geriatric patients, and whether using PVI could reduce blood transfusion and vasopressor requirements. METHODS: One-hundred geriatric patients who underwent elective hip and knee arthroplasty were included, assigned to either PVI group (volume replacement was PVI guided) or to a control group (volume replacement was based on traditional methods). Perioperative hemodynamic parameters, infusion rate of crystalloids, colloids, blood/blood products, ephedrine hydrochloride requirements and perioperative urine outputs were recorded. RESULTS: Crystalloid infusion rate was higher (9.5 vs. 6.8 ml/kg/h, p<0.001) and ephedrine requirement was lower (2.0% vs. 38.0%, p<0.001) in group PVI. Postoperatively, the percentage of patients with high BUN, creatinine, and lactate levels were higher among controls (p<0.001). PVI group had significantly lower mean heart rate intraoperatively. CONCLUSIONS: Our findings suggest that intraoperative fluid replacement guided by PVI monitoring provides hemodynamic stability, preserves normal levels of BUN, creatinine, and lactate, and reduces unnecessary use of vasopressor agents in elderly surgical patients.

References

  • Ansari BM, Zochios V, Falter F, Klein AA. Physiological controversies and methods used to determine fluid responsiveness: a qualitative systematic review. Anaesthesia 2016;71:94-105.

Geriyatrik cerrahi hastalarının intraoperatif sıvı yönetiminde pleth değişkenlik indeksinin potansiyel değeri

Year 2022, Volume 7, Issue 1, 15 - 20, 28.03.2022
https://doi.org/10.25000/acem.1080760

Abstract

Amaç: Bu çalışma, geriyatrik hastalarda kalça ve diz artroplastisi sırasında PVI monitörizasyonunun optimal intravasküler volüm replasmanı üzerindeki etkilerini ve PVI kullanımının kan transfüzyonu ve vazopressör gereksinimlerini azaltıp azaltmayacağını belirlemek için tasarlanmıştır. Yöntem: Elektif kalça ve diz artroplastisi uygulanan 100 geriyatrik hasta, PVI grubuna (volüm replasmanı PVI rehberliğinde yapıldı) veya kontrol grubuna (geleneksel yöntemlere dayalı volüm replasmanı yapıldı) dahil edildi. Perioperatif hemodinamik parametreler, kristaloidlerin, kolloidlerin, kan ve kan ürünlerinin infüzyon miktarı, efedrin hidroklorür gereksinimleri ve perioperatif idrar çıkışları kaydedildi. Bulgular: Kristalloid transfüzyonu grup PVI'da daha yüksekti (9,5'e karşı 6,8 ml/kg/saat, p<0,001) ve efedrin gereksinimi daha düşüktü (%2,0'ye karşı %38,0, p<0,001). Ameliyat sonrası BUN, kreatinin ve laktat düzeyleri yüksek olan hastaların yüzdesi kontroller arasında daha yüksekti (p<0,001). PVI grubu, intraoperatif anlamlı olarak daha düşük ortalama kalp hızına sahipti. Sonuç: Bulgularımız, PVI monitorizasyonu ile intraoperatif sıvı replasmanının hemodinamik stabilite sağladığını, normal BUN, kreatinin ve laktat seviyelerini koruduğunu ve geriyatrik cerrahi hastalarda gereksiz vazopressör ajan kullanımını azalttığını göstermektedir. Anahtar sözcükler: Geriyatrik

References

  • Ansari BM, Zochios V, Falter F, Klein AA. Physiological controversies and methods used to determine fluid responsiveness: a qualitative systematic review. Anaesthesia 2016;71:94-105.

Details

Primary Language English
Subjects Surgery
Journal Section Original Research
Authors

Meliha ORHON ERGÜN> (Primary Author)
MARMARA ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0001-8158-1393
Türkiye


Seniyye ZENGİN>
MARMARA ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0003-1795-6597
Türkiye


Beliz BİLGİLİ>
MARMARA ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0003-3466-0771
Türkiye


Tümay UMUROĞLU>
MARMARA ÜNİVERSİTESİ, TIP FAKÜLTESİ
0000-0001-6887-1740
Türkiye

Publication Date March 28, 2022
Published in Issue Year 2022, Volume 7, Issue 1

Cite

Bibtex @research article { acem1080760, journal = {Archives of Clinical and Experimental Medicine}, eissn = {2564-6567}, address = {hırkai şerif mah. keçeci çeşmesi sok. doktorlar sitesi b blok 6/7 Fatih İstanbul Türkiye}, publisher = {Mustafa HASBAHÇECİ}, year = {2022}, volume = {7}, number = {1}, pages = {15 - 20}, doi = {10.25000/acem.1080760}, title = {Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients}, key = {cite}, author = {Orhon Ergün, Meliha and Zengin, Seniyye and Bilgili, Beliz and Umuroğlu, Tümay} }
APA Orhon Ergün, M. , Zengin, S. , Bilgili, B. & Umuroğlu, T. (2022). Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients . Archives of Clinical and Experimental Medicine , 7 (1) , 15-20 . DOI: 10.25000/acem.1080760
MLA Orhon Ergün, M. , Zengin, S. , Bilgili, B. , Umuroğlu, T. "Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients" . Archives of Clinical and Experimental Medicine 7 (2022 ): 15-20 <https://dergipark.org.tr/en/pub/acem/issue/69109/1080760>
Chicago Orhon Ergün, M. , Zengin, S. , Bilgili, B. , Umuroğlu, T. "Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients". Archives of Clinical and Experimental Medicine 7 (2022 ): 15-20
RIS TY - JOUR T1 - Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients AU - MelihaOrhon Ergün, SeniyyeZengin, BelizBilgili, TümayUmuroğlu Y1 - 2022 PY - 2022 N1 - doi: 10.25000/acem.1080760 DO - 10.25000/acem.1080760 T2 - Archives of Clinical and Experimental Medicine JF - Journal JO - JOR SP - 15 EP - 20 VL - 7 IS - 1 SN - -2564-6567 M3 - doi: 10.25000/acem.1080760 UR - https://doi.org/10.25000/acem.1080760 Y2 - 2022 ER -
EndNote %0 Archives of Clinical and Experimental Medicine Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients %A Meliha Orhon Ergün , Seniyye Zengin , Beliz Bilgili , Tümay Umuroğlu %T Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients %D 2022 %J Archives of Clinical and Experimental Medicine %P -2564-6567 %V 7 %N 1 %R doi: 10.25000/acem.1080760 %U 10.25000/acem.1080760
ISNAD Orhon Ergün, Meliha , Zengin, Seniyye , Bilgili, Beliz , Umuroğlu, Tümay . "Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients". Archives of Clinical and Experimental Medicine 7 / 1 (March 2022): 15-20 . https://doi.org/10.25000/acem.1080760
AMA Orhon Ergün M. , Zengin S. , Bilgili B. , Umuroğlu T. Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients. Arch Clin Exp Med. 2022; 7(1): 15-20.
Vancouver Orhon Ergün M. , Zengin S. , Bilgili B. , Umuroğlu T. Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients. Archives of Clinical and Experimental Medicine. 2022; 7(1): 15-20.
IEEE M. Orhon Ergün , S. Zengin , B. Bilgili and T. Umuroğlu , "Potential value of pleth variability index in intraoperative fluid management of geriatric surgical patients", Archives of Clinical and Experimental Medicine, vol. 7, no. 1, pp. 15-20, Mar. 2022, doi:10.25000/acem.1080760

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