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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

SVV are "much more valuable for prediction of volume responsiveness than CVP" and that PVI "is of high value, especially regarding sensitivity and negative predictive value. Thus, volume responsiveness is not to be expected when PVI is low."

Fluid administration is usually the first intervention in hemodynamically unstable patients to improve status and enable end organ preservation.2 Fluid is given to increase a patient's cardiac output, but only about half of critically ill patients actually increase cardiac output after fluid administration.3 Unnecessary fluid administration should be avoided because it's associated with increased morbidity and mortality.3 Clinical decision making is challenging using traditional invasive measurements such as central venous pressure, stroke volume/index, cardiac output/index, and pulmonary capillary wedge pressure, as they have not been shown to predict fluid responsiveness.5 Newer, dynamic indices such as SVV and pulse pressure variation can accurately predict fluid responsiveness and improve outcomes,but are invasive and/or complex and have a high procedural cost, estimated to be about $225 with an SVV monitoring system in one cost analysis.7 PVI is also a dynamic measurement of changes over respiratory variations, but does so with the Masimo SET plethysmograph waveform instead of the arterial waveform. In contrast to other available methods, PVI is noninvasive, easy to use, and has no incremental procedural cost because pulse oximetry monitoring is already performed on all surgical and intensive care patients. No other pulse oximetry technology provides a parameter like PVI. Once Masimo SET® pulse oximetry or rainbow® Pulse CO-Oximetry™ with PVI is available in a hospital, it can be utilized in all patients.

Previously, PVI has been shown to help clinicians assess fluid responsiveness in adult surgical
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