Use of plethysmographic variability index derived from the Massimo® pulse oximeter to predict fluid or preload responsiveness: a systematic review and meta‐analysis

• Published in: Anaesthesia 2012-07, Vol.67 (7), p.777-783
• Main Authors: Yin, J. Y., Ho, K. M.
• Format: Article
• Language: English
• Subjects: Anesthesia; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Critical care; Critical Care - methods; Fluid Therapy - methods; Humans; Medical equipment; Medical sciences; Oximetry - instrumentation; Oximetry - methods; Perioperative Care - methods; Plethysmography - methods; Surgery; Systematic review
• ISSN: 0003-2409; 1365-2044
• DOI: 10.1111/j.1365-2044.2012.07117.x

Summary This systematic review and meta‐analysis assessed the accuracy of plethysmographic variability index derived from the Massimo® pulse oximeter to predict preload responsiveness in peri‐operative and critically ill patients. A total of 10 studies were retrieved from the literature, involving 328 patients who met the selection criteria. Overall, the diagnostic odds ratio (16.0; 95% CI 5–48) and area under the summary receiver operating characteristic curve (0.87; 95% CI 0.78–0.95) for plethysmographic variability index to predict fluid or preload responsiveness was very good, but significant heterogeneity existed. This could be explained by a lower accuracy of plethysmographic variability index in spontaneously breathing or paediatric patients and those studies that used pre‐load challenges other than colloid fluid. The results indicate specific directions for future studies.