Photoplethysmographic and pulse pressure variations during abdominal surgery

Background Respiratory variations in pulse pressure (ΔPP) predict fluid responsiveness during mechanical ventilation. Variations in pulse oximetry plethysmography amplitude (ΔPOP) are proposed as a non‐invasive alternative. Large variations in ΔPOP and poor agreement between ΔPP and ΔPOP are found i...

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Bibliographic Details
Published in:Acta anaesthesiologica Scandinavica 2011-11, Vol.55 (10), p.1221-1230
Main Authors: HØISETH, L. Ø., HOFF, I. E., SKARE, Ø., KIRKEBØEN, K. A., LANDSVERK, S. A.
Format: Article
Language:English
Subjects:
Abdomen - surgery
Anesthesia
Anesthesia, General
Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy
Area Under Curve
Biological and medical sciences
Blood Pressure - physiology
Central Venous Pressure - physiology
Female
Fluid Therapy
Heart Rate - physiology
Humans
Intraoperative Period
Male
Medical sciences
Middle Aged
Monitoring, Intraoperative
Oximetry
Photoplethysmography - methods
Preanesthetic Medication
ROC Curve
Signal Processing, Computer-Assisted
Stroke Volume - physiology
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Summary:Background Respiratory variations in pulse pressure (ΔPP) predict fluid responsiveness during mechanical ventilation. Variations in pulse oximetry plethysmography amplitude (ΔPOP) are proposed as a non‐invasive alternative. Large variations in ΔPOP and poor agreement between ΔPP and ΔPOP are found in intensive care unit patients. General anaesthesia is suggested to reduce variability of ΔPOP and improve agreement between the variables. We evaluated the variability of the agreement between and the diagnostic values of ΔPP and ΔPOP during ongoing open abdominal surgery. The variability of diagnostic methods in specific clinical conditions is important, as this reflects the stability over time during which clinical decisions are made. Methods Observational study during open abdominal surgery in general anaesthesia. ΔPP and ΔPOP were calculated semi‐automatically from recording periods of approximately 5 min both before and after fluid challenges. Fluid responsiveness was evaluated by changes in stroke volume (oesophageal Doppler) after 250 ml colloid. Results Thirty‐four fluid challenges were performed in 25 patients. Variance both within registration periods and between patients were significantly larger for ΔPOP than for ΔPP (54.1% vs. 22.1% and 69.6% vs. 22.6%, respectively, both P 
ISSN:0001-5172
1399-6576
DOI:10.1111/j.1399-6576.2011.02527.x