IRVINE, Calif., April 19, 2012 /PRNewswire/ -- Masimo (NASDAQ: MASI) announced today that a study published in the current issue of peer-reviewed journal BioScience Trends demonstrates that noninvasive and continuous monitoring of Masimo Pleth Variability Index (PVI®) helps clinicians assess fluid responsiveness during major abdominal surgery and concluded that PVI results were similar to invasive, more expensive stroke volume variation (SVV). Other traditional hemodynamic variables were not significant for assessing fluid responsiveness.
In the study of 51 patients, 31 patients were responders to fluid administration and 20 were non-responders, defined as a >10% increase stroke volume index (the amount of blood a heart pumps in each beat) after fluid administration. PVI was measured from a Masimo Radical-7 and LNOP Adt and SVV was measured from a Vigileo® device and Flotrac® cathether. A PVI threshold of >13.5% discriminated responders with a sensitivity of 77% and a specificity of 81%, while an SVV threshold of >12.5% discriminated responders with a sensitivity of 87.9% and a specificity of 83.3%. The areas under the curve (AUC) for fluid prediction for PVI and SVV were 0.79 and 0.86 respectively, while the AUCs for stroke volume index, cardiac index, central venous pressure, and mean arterial pressure were not statistically significant.
"There was no significant difference between the areas under the receiver operating characteristic curve for SVV and PVI," the study's authors stated. "Our results showed that SVV and PVI could predict fluid responsiveness during major abdominal surgery in complicated dynamic conditions" and concluded that "monitoring fluid responsiveness using a noninvasive device may help for fluid optimization in the operating room, especially in some patients who do not need invasive artery monitoring."
Multiple studies have shown PVI helps clinicians assess fluid responsiveness in surgical, mechanically ventilated patients – helping clinicians improve fluid management to reduce patient risk, . Although fluid administration is critical to optimizing patient status and enabling end organ preservation, unnecessary fluid administration is associated with increased morbidity and mortality. Because SVV has been shown in previous studies to be an accurate method to predict fluid responsiveness and optimize fluid management in surgical and intensive care patients, the similar accuracy shown with noninvasive PVI suggests that PVI-guided fluid optimization may also help guide fluid management to minimize patient risk, as was already shown in one randomized controlled trial.
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