脉搏灌注指数变异在围手术期容量治疗监测中的应用

脉搏灌注指数变异(plethysmographic variability index,PVI)是动态的容量监测指标,作为新一代脉搏氧饱和度仪的测量参数,通过脉搏波形分析技术可以进行连续瞬时监测。PVI可准确地指导液体复苏,维持最佳前负荷,防止有效循环血容量不足导致的低灌注和血容量过多导致的组织水肿,有利于更好的平衡液体管理,是一种简便、有效的实时监测手段。与传统静态的血流动力学参数相比,PVI能准确无创的预测容量治疗反应,因而在优化心输出量和便捷临床应用方面更有优势。然而,PVI受多种因素影响且不能用于自主呼吸和心律失常的患者,因此临床应用时应该综合考虑其影响因素,结合其他方法指导容量治疗。

Application of Plethysmographic Variability Index for MonitoringPerioperative Fluid Therapy

ABSTRACT:Plethysmographic variability index (PVI) isa dynamical volume monitoring tool, which is a new pulse oximeter''smeasurement parameter for continuous instantaneous monitoring through the pulse waveform analysis techniques. PVI can accuratelyguide fluid resuscitation, maintain the optimal preload, and prevent inadequate circulating blood volume that leads to low perfusion or toomuch blood volume leading to tissue edema. Therefore, PVI is a simple and effective tool for real-time monitoring that can facilitite betterliquid management. In contrast to static hemodynamic parameters, PVI can accurately predict fluid resuscitation response, thus has advantages with respective of optimized cardiac output and clinical application. However, PVI is influenced by many factors and can not beused in spontaneous breathing and arrhythmia patients. In clinical practice, we should consider these factors and combine with othermethods to guide fluid therapy