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Masimo's Noninvasive Pleth Variability Index as Accurate as Invasive Stroke Volume Variation for Fluid Responsiveness Assessment in Cardiac Surgery
Date:8/7/2012

IRVINE, Calif., Aug. 7, 2012 /PRNewswire/ -- Masimo (NASDAQ: MASI) announced today a new study in the Journal of Anesthesia demonstrates that for fluid responsiveness assessment, Masimo's noninvasive Pleth Variability Index (PVI®) is as accurate as invasive stroke volume variation (SVV) in patients undergoing cardiopulmonary bypass surgery.1 In the study conducted at the University Medical Center Hamburg-Eppendorf in Hamburg, Germany, researchers evaluated 18 patients who underwent elective cardiopulmonary bypass surgery. All patients had a central venous catheter as well as a femoral arterial catheter monitored with the PiCCO monitor (PiCCO2; Pulsion Medical Systems) for continuous measurement of SVV and intermittent assessment of cardiac index.  PVI was measured using the Masimo Radical-7® monitor. 

Fluid responsiveness was defined as a >10% increase in cardiac index after fluid administration and non-responsiveness was defined as <10% increase in cardiac index after fluid administration. Out of 22 fluid challenges, four resulted in a significant increase in cardiac index, while 18 did not. The optimal threshold value for fluid responsiveness was >11% for SVV and >16% for PVI. Both PVI and SVV correctly identified each of the four responders (100% sensitivity), while PVI identified 16 of 18 non-responders (89% sensitivity) and SVV identified 13 of 18 non-responders (72% sensitivity). Receiver operator characteristic curve analysis, which takes into account both sensitivity and specificity, showed a 0.95 area under the curve (AUC) for PVI and 0.87 AUC for SVV (p=0.31 for difference between PVI and SVV).  Central venous pressure was a poor predictor of fluid responsiveness, with an AUC of 0.19.

The authors stated that both PVI and
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