The use of Pleth Variability Index (PVI) for the assessment of patients with dehydration in the pediatric emergency department

Abstract

Objective: There is not a non-invasive, valid, and reliable criterion yet that can be used to determine the degree of dehydration and responsiveness to fluid treatment. In the literature, Pleth Variability Index (PVI) has been studied as one of the additional tools that can be used to determine the degree of dehydration. Studies on this topic have been conducted mainly on patients who are connected to mechanical ventilators. This study was conducted to assess the feasibility of PVI measurement in paediatric patients who breathe spontaneously, are dehydrated moderately and need fluid repletion. Material and Methods: For this purpose, PVI, blood gas (pH, HCO3, lactate), and body weights of the patients were measured before and after fluid replacement. The delta (Δ) values were calculated by taking the difference between the values before and after fluid therapy, and the correlation was examined. Results: After one hour of fluid treatment, weight, physical examination, blood gas (bicarbonate, lactate, pH) values improved significantly compared to pre-fluid levels, and high PVI values were found to decrease significantly. However, no significant correlation was found between PVI change (ΔPVI) and other variables (Δ kilo, pH, lactate, bicarbonate), which are used to determine the degree of dehydration. Conclusion: According to the findings of our study, PVI alone does not provide adequate and reliable data in children who are dehydrated moderately and breathe spontaneously