Is Dynamic Non-Invasive Monitoring Helpful for Fluid Responsiveness in Lateral Decubitus Position in Thoracic Surgery Population? Toraks Cerrahisi Hastalarında Lateral Dekübit Pozisyonda, İnvaziv Olmayan Dinamik Monitörizasyon Sıvı Yanıtlılığını Değerlendirmede Faydalı mıdır?
Anestezi Dergisi, cilt.33, sa.3, ss.190-196, 2025 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 33 Sayı: 3
- Basım Tarihi: 2025
- Doi Numarası: 10.54875/jarss.2025.36097
- Dergi Adı: Anestezi Dergisi
- Derginin Tarandığı İndeksler: Scopus, Central & Eastern European Academic Source (CEEAS), EMBASE, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.190-196
- Anahtar Kelimeler: fluid responsiveness, pleth variability index, Thoracic anesthesia
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: The Pleth Variability Index (PVI) is a non-invasive and continuous dynamic trend monitoring that reflects a patient’s volume status. The threshold value of PVI varies significantly across patient groups and surgical types. In this study, we evaluated patients’ volume status using PVI and mean arterial pressure (MAP) while they were in the lateral position and after a mini fluid-responsiveness test. Methods: After obtaining approval from the hospital ethics committee and patient consent forms, a total of 63 patients scheduled for open thoracotomy in the Right lateral decubitus (RLD) or left lateral decubitus (LLD) position were included in the study. Patients who had undergone fasting for 8–10 hours and were in the supine position were monitored at baseline (T1) using standard monitoring along with PVI measurement via Masimo Root-7. Measurements were recorded after induction (T2) and once the patients were turned to the RLD or LLD position (T3). After administering 3 mL kg-1 of ringer lactate over 3 minutes based on the patients’ ideal body weight (T4) data was recorded, and the study was concluded before the incision. Changes in MAP and PVI in either a positive or negative direction were recorded, and their correlations were analyzed. Data was analyzed using SPSSv25 software. Results: When patients were positioned in the RLD position after induction, a significant decrease in MAP was observed, while no significant change was noted in PVI values. However, during the mini fluid-responsiveness test, the PVI trend indicated a shift in favor of increased volume in both decubitus positions. No correlation was found between MAP and PVI values at T3-T4 time points. Conclusion: During the minimal fluid-responsiveness test, the trend monitor PVI decreased in both decubitus positions, indicating increased volume status in unit values. However, we were unable to establish the expected correlation with MAP, which can be influenced by multiple variables.