Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study
Yıl: 2022 Cilt: 42 Sayı: 2 Sayfa Aralığı: 79 - 86 Metin Dili: İngilizce DOI: 10.5336/medsci.2021-85651 İndeks Tarihi: 08-07-2022
Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study
Öz: ABSTRACT Objective: The aim of this study was to compare the sensitivity
and specificity of Pleth Variability Index (PVI) and distensibility of inferior
vena cava (dIVC) in fluid responsiveness of patients with sepsis. Material and
Methods: Forty patients over 18 years of age who underwent fluid replacement
for sepsis in the intensive care unit were included in the study. In our
study, the patients were divided into 2 groups as those who had less than 15%
increase in cardiac output (CO), and those who had more than 15% increase in
CO after fluid replacement (fluid responders and non-responders). Before fluid
replacement, demographic data of the patients (age, weight, cause of sepsis,
body surface area, SOFA score), vital parameters (systolic arterial pressure, diastolic
arterial pressure, mean arterial pressue, heart rate) and measuredd values
(maximum diameter of vena cava inferior, minimum diameter of vena cava
inferior, central venous pressure, PVI, CO, and stroke volume) were recorded.
After applying crystalloid in a dose of 10 mL/kg for 15 minutes, the recorded
parameters were repeated at 15th minute. Results: When receiver operating
characteristic (ROC) analysis was performed for dIVC, the area under the curve
(AUC) was found to be 0.833 (0.739-0.926). The threshold value was found to
be 17.52%, sensitivity was 77.5%, and specificity was 72.5%. When ROC analysis
was performed for PVI, AUC was found to be 0.889 (0.817-0.962). The
threshold value was found as 12.50%, sensitivity was 72.5%, and specificity
was 92.5%. Conclusion: PVI was found to be more specific but less sensitive
than dIVC. dIVC is less sensitive and less specific than central venous pressure.
However, dIVC and PVI can give useful results in patients who have contraindication
of an invasive technique.
Anahtar Kelime: Sepsis Hastalarında Perfüzyon Belirteci Olarak Pleth Değişkenlik İndeksi ve Vena Kava İnferior Gerilebilirliğinin Karşılaştırılması: Gözlemsel Çalışma
Öz: ÖZET Amaç: Bu çalışmanın amacı Pleth Değişkenlik İndeksi (PVI) ve inferior
vena kava distensibilitesinin (dIVC) sepsisli hastalarda sıvı yanıtını değerlendirmedeki
duyarlılığını ve özgüllüğünü karşılaştırmaktır. Gereç ve
Yöntemler: Çalışmaya, yoğun bakım ünitesindeki sepsis tanısı almış sıvı replasmanı
uygulanacak 18 yaş üstü bireylerden 40 hasta dâhil edildi. Çalışmamızda
hastalar, sıvı replasmanı sonrası “kardiyak output”ta [cardiac output
(CO)] %15’ten az ve %15’ten fazla artış olan (sıvıya cevap verenler ve vermeyenler)
olarak 2’ye ayrıldı. Hastaların sıvı replasmanı öncesi demografik
verileri (yaş, kilo, sepsis nedeni, vücut yüzey alanı, SOFA skoru), vital parametreleri
(sistolik arter basıncı, diaystolik arter basıncı, ortlama arter basıncı,
kalp atım hızı) ve ölçüm değerleri (vena cava inferior maksimum çapı, vena
cava inferior minimum çapı, santral venöz basınç, PVI, CO, vuruş hacmi)
kayıt edildi. Hastalara 15 dk boyunca 10 mL/kg kristaloid uygulandıktan sonra
kayıt edilen parametreler tekrarlandı. Bulgular: dIVC için alıcı işletim karakteristiği
[receiver operating characteristic (ROC)] analizi yapıldığında, eğri
altında kalan alan [area under the curve (AUC)] 0,833 (0,739-0,926) bulunmuştur.
Eşik değer %17,52 bulunmuş olup; duyarlılık %77,5, özgüllük %72,5
bulunmuştur. PVI için ROC analizi yapıldığında, AUC 0,889 (0,817-0,962)
bulunmuştur. Eşik değer %12,50 bulunmuş olup; duyarlılık %72,5, özgüllük
%92,5 bulunmuştur. Sonuç: PVI’nın, dIVC’den daha spesifik ancak daha az
duyarlı olduğu bulundu. dIVC, santral venöz basınçtan daha az duyarlı ve
daha az spesifik bulundu. Bununla birlikte dIVC ve PVI, invaziv bir teknik
için kontrendikasyonu olan hastalarda faydalı sonuçlar verebilir.
Anahtar Kelime: Belge Türü: Makale Makale Türü: Araştırma Makalesi Erişim Türü: Erişime Açık
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APA | Göktürk O, Avcı O, Gündoğdu O, Isbir A, ÖZDEMİR KOL İ, GÜRSOY S, KAYGUSUZ K (2022). Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study. , 79 - 86. 10.5336/medsci.2021-85651 |
Chicago | Göktürk Orhan,Avcı Onur,Gündoğdu Oğuz,Isbir Ahmet Cemil,ÖZDEMİR KOL İCLAL,GÜRSOY SİNAN,KAYGUSUZ KENAN Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study. (2022): 79 - 86. 10.5336/medsci.2021-85651 |
MLA | Göktürk Orhan,Avcı Onur,Gündoğdu Oğuz,Isbir Ahmet Cemil,ÖZDEMİR KOL İCLAL,GÜRSOY SİNAN,KAYGUSUZ KENAN Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study. , 2022, ss.79 - 86. 10.5336/medsci.2021-85651 |
AMA | Göktürk O,Avcı O,Gündoğdu O,Isbir A,ÖZDEMİR KOL İ,GÜRSOY S,KAYGUSUZ K Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study. . 2022; 79 - 86. 10.5336/medsci.2021-85651 |
Vancouver | Göktürk O,Avcı O,Gündoğdu O,Isbir A,ÖZDEMİR KOL İ,GÜRSOY S,KAYGUSUZ K Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study. . 2022; 79 - 86. 10.5336/medsci.2021-85651 |
IEEE | Göktürk O,Avcı O,Gündoğdu O,Isbir A,ÖZDEMİR KOL İ,GÜRSOY S,KAYGUSUZ K "Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study." , ss.79 - 86, 2022. 10.5336/medsci.2021-85651 |
ISNAD | Göktürk, Orhan vd. "Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study". (2022), 79-86. https://doi.org/10.5336/medsci.2021-85651 |
APA | Göktürk O, Avcı O, Gündoğdu O, Isbir A, ÖZDEMİR KOL İ, GÜRSOY S, KAYGUSUZ K (2022). Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study. Türkiye Klinikleri Tıp Bilimleri Dergisi, 42(2), 79 - 86. 10.5336/medsci.2021-85651 |
Chicago | Göktürk Orhan,Avcı Onur,Gündoğdu Oğuz,Isbir Ahmet Cemil,ÖZDEMİR KOL İCLAL,GÜRSOY SİNAN,KAYGUSUZ KENAN Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study. Türkiye Klinikleri Tıp Bilimleri Dergisi 42, no.2 (2022): 79 - 86. 10.5336/medsci.2021-85651 |
MLA | Göktürk Orhan,Avcı Onur,Gündoğdu Oğuz,Isbir Ahmet Cemil,ÖZDEMİR KOL İCLAL,GÜRSOY SİNAN,KAYGUSUZ KENAN Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study. Türkiye Klinikleri Tıp Bilimleri Dergisi, vol.42, no.2, 2022, ss.79 - 86. 10.5336/medsci.2021-85651 |
AMA | Göktürk O,Avcı O,Gündoğdu O,Isbir A,ÖZDEMİR KOL İ,GÜRSOY S,KAYGUSUZ K Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2022; 42(2): 79 - 86. 10.5336/medsci.2021-85651 |
Vancouver | Göktürk O,Avcı O,Gündoğdu O,Isbir A,ÖZDEMİR KOL İ,GÜRSOY S,KAYGUSUZ K Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study. Türkiye Klinikleri Tıp Bilimleri Dergisi. 2022; 42(2): 79 - 86. 10.5336/medsci.2021-85651 |
IEEE | Göktürk O,Avcı O,Gündoğdu O,Isbir A,ÖZDEMİR KOL İ,GÜRSOY S,KAYGUSUZ K "Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study." Türkiye Klinikleri Tıp Bilimleri Dergisi, 42, ss.79 - 86, 2022. 10.5336/medsci.2021-85651 |
ISNAD | Göktürk, Orhan vd. "Comparison of Pleth Variability Index and Inferior Vena Cava Distensibility as a Perfusion Indicator in Sepsis Patients: An Observational Study". Türkiye Klinikleri Tıp Bilimleri Dergisi 42/2 (2022), 79-86. https://doi.org/10.5336/medsci.2021-85651 |