Prediction of fluid responsiveness in mechanically ventilated patients in surgical intensive care unit by pleth variability index and inferior vena cava diameter

Abstract

Deleterious effect of volume overload on the different organs and body tissues raise the need for new devices and techniques for assessment of fluid responsiveness in the perioperative period. Static methods for fluid management as CVP became not reliable. Dynamic ones are more preferable nowadays due to their accuracy and being more presentable for actual blood volume and its changes during lung and heart cycles including their interactions. Many studies have been carried out trying for discovering new dynamic maneuvers characterized by being easy, non-invasive, with fewer complications, and in the same time with high sensitivity and specificity. This study was aiming for comparing the reliability and effectiveness of the PVI and dIVC as easy and non-invasive predictors of perioperative fluid responsiveness by simultaneous recording in all our surgical ICU sedated mechanically ventilated patients. PLR was used in our study as a harmless reversible technique for fluid challenge, and TTE was used as a gold standard method of identification of fluid responsiveness by an increase in CI≥ 15% post PLR.