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Comparison of pulse pressure variation and pleth variability index in the prone position in pediatric patients under 2 years old

대한마취과학회지 2019년 72권 5호 p.466 ~ 471
 ( Ji Sang-Hwan ) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine

 ( Song In-Kyung ) - University of Ulsan College of Medicine Asan Medical Center Department of Anesthesiology and Pain Medicine
 ( Jang Young-Eun ) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
 ( Kim Eun-Hee ) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
 ( Lee Ji-Hyun ) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
 ( Kim Jin-Tae ) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine
 ( Kim Hee-Soo ) - Seoul National University Hospital Department of Anesthesiology and Pain Medicine

Abstract


Background: The assessment of intravascular volume status is very important especially in children during anesthesia. Pulse pressure variation (PPV) and pleth variability index (PVI) are well known parameters for assessing intravascular volume status and fluid responsiveness. We compared PPV and PVI for children aged less than two years who underwent surgery in the prone position.

Methods: A total of 27 children were enrolled. We measured PPV and PVI at the same limb during surgery before and after changing the patients’ position from supine to prone. We then compared PPV and PVI at each period using Bland-Altman plot for bias between the two parameters and for any correlation. We also examined the difference between before and after the position change for each parameter, along with peak inspiratory pressure, heart rate and mean blood pressure.

Results: The bias between PPV and PVI was ?2.2% with a 95% limits of agreement of ?18.8% to 14.5%, not showing significant correlation at any period. Both PPV and PVI showed no significant difference before and after the position change.

Conclusions: No significant correlation between PVI and PPV was observed in children undergoing surgery in the prone position. Further studies relating PVI, PPV, and fluid responsiveness via adequate cardiac output estimation in children aged less than 2 years are required.

키워드

Arterial pressure; Child; Fluid therapies; Plethysmography; Prone positions
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