Relation between pulse oximetry plethysmographic waveform amplitude induced by passive leg raising and cardiac index in spontaneously breathing subjects - 12/08/11
Abstract |
Introduction |
Previous studies suggested that variation of pulse oximetric plethysmographic (POP) waveform amplitude (ΔPOP) could predict fluid responsiveness in mechanically ventilated patients. Our objective was to correlate the variations of ΔPOP and the variations of cardiac index (CI) induced by passive leg raising (PLR) in spontaneously breathing volunteers.
Methods |
We studied 26 spontaneously breathing volunteers using a pulse oximeter attached to the middle finger. We assessed hemodynamic variables, including ΔPOP (%) (POPmax − POPmin)/[(POPmax + POPmin)/2] and CI determined by transthoracic echocardiography at baseline (eg, semirecumbent position), during PLR at 60°, and back to baseline.
Results |
Cardiac index significantly increased from 2.2 to 2.5 L/min·m2 (P < .01) at 60° PLR. Conversely, ΔPOP significantly decreased from 22% to 15% (P < .01) at 60° PLR. There was a weak correlation between CI and ΔPOP variations at 60° PLR (r = 0.40; P < .01). The area under curve of the receiver operating characteristic curve for ΔPOP as a predictor of an increase of CI of 15% was not significant (0.67 ± 0.10; P = .16).
Conclusion |
The variation of ΔPOP induced by PLR is not an accurate predictor of increase in CI.
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| ☆ | Authors' contributions: SD, SC, and PR conceived the study and analyzed the curves. SD, SC, PN, YF, MOJ, BMP, ER, and PR collected the data. SD and PR performed the statistical analysis and drafted the manuscript. BR and PN helped to draft the manuscript. All authors read and approved the final manuscript. |
| ☆☆ | Competing interests: The author(s) declare that they have no competing interests. The manufacturers (Datascope Masimo [Masimo, France], Oridion [Jerusalem, Israel], and Sonosite [Villebon-sur-Yvette, France]) provided the material free of charge. |
Vol 28 - N° 4
P. 505-510 - mai 2010 Retour au numéro
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