May 15, 2013
(NASDAQ: MASI) announced today a new study in the
Journal of Anesthesia
demonstrates that Masimo's noninvasive PVI
can be used to help clinicians accurately assess fluid responsiveness in mechanically ventilated children under general anesthesia,
adding to the growing body of evidence that shows the efficacy of PVI across a wide range of patient populations.
Hemodynamic instability is a common challenge in surgical and critically ill patients. When necessary, fluid administration is critical to optimizing patient status and enabling end organ preservation,
but unnecessary fluid administration is associated with increased morbidity and mortality.
The decision whether to administer fluid in an attempt to improve cardiac output can be challenging because traditional invasive methods can be inaccurate at predicting fluid responsiveness while newer dynamic indicators for assessing fluid responsiveness are accurate but are either invasive, operator-dependent, or costly.
In the study conducted at Seoul
Seoul, South Korea
, researchers evaluated 33 pediatric patients undergoing neurosurgery, ranging in age from 6 months to 9 years. Investigators evaluated measurements from commonly used invasive and complex techniques including: central venous pressure (CVP), systolic pressure variation (SPV), pulse pressure variation (PPV), change in inferior vena cava diameter measurement (∆IVCD), and respiratory aortic blood flow velocity (ΔV peak), while also evaluating Masimo's noninvasive and automated PVI (Masimo Radical-7
). All measurements were compared before volume expansion and whether their values were associated with a significant change in stroke volume index (SVI). There were 15 volume responders (≥10% increase in SVI after volume expansion) and 18 non-responders (<10% increase in SVI after volume expansion). Researchers found that only PVI >11% (with sensitivity of 73.3% and specificity of 86.7%) and ΔV peak of >11% (with sensitivity of 86.7% and specificity of 72.2%) predicted fluid responsiveness. All other measures (CVP, SPV, PPV, ∆IVCD) were not associated with an improvement in SVI and therefore were poor predictors of fluid responsiveness.
The researchers noted that while both ΔV peak and PVI are noninvasive and have been shown to be good indicators of fluid responsiveness in various clinical settings, ΔV peak is dependent on a skilled operator with costly imaging equipment, while PVI can be used by clinicians who can use a pulse oximeter.