J Clin Monit Comput - Pulse oximeter plethysmograph variation and its relationship to the arterial waveform in mechanically ventilated children.

Tópicos

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Resumo

The variations induced by mechanical ventilation in the arterial pulse pressure and pulse oximeter plethysmograph waveforms have been shown to correlate closely and be effective in adults as markers of volume responsiveness. The aims of our study were to investigate: (1) the feasibility of recording plethysmograph indices; and (2) the relationship between pulse pressure variation (PP), plethysmograph variation (POP) and plethysmograph variability index (PVI) in a diverse group of mechanically ventilated children. A prospective, observational study was performed. Mechanically ventilated children less than 11 years of age, with arterial catheters, were enrolled during the course of their clinical care in the operating room or in the pediatric intensive care unit. Real time monitor waveforms and trend data were recorded. PP and POP were manually calculated and the relationships between PP, POP and PVI were compared using Bland-Altman analysis and Pearson correlations. Forty-nine children were recruited; four (8%) subjects were excluded due to poor quality of the plethysmograph waveforms. PP and POP demonstrated a strong correlation (r = 0.8439, P < 0.0001) and close agreement (Bias = 1.44 ? 6.4%). PVI was found to correlate strongly with PP (r = 0.7049, P < 0.0001) and POP (r = 0.715, P < 0.0001). This study demonstrates the feasibility of obtaining plethysmographic variability indices in children under various physiological stresses. These data show a similarly strong correlation to that described in adults, between the variations induced by mechanical ventilation in arterial pulse pressure and the pulse oximeter plethysmograph.

Resumo Limpo

variat induc mechan ventil arteri puls pressur puls oximet plethysmograph waveform shown correl close effect adult marker volum respons aim studi investig feasibl record plethysmograph indic relationship puls pressur variat pp plethysmograph variat pop plethysmograph variabl index pvi divers group mechan ventil children prospect observ studi perform mechan ventil children less year age arteri cathet enrol cours clinic care oper room pediatr intens care unit real time monitor waveform trend data record pp pop manual calcul relationship pp pop pvi compar use blandaltman analysi pearson correl fortynin children recruit four subject exclud due poor qualiti plethysmograph waveform pp pop demonstr strong correl r p close agreement bias pvi found correl strong pp r p pop r p studi demonstr feasibl obtain plethysmograph variabl indic children various physiolog stress data show similar strong correl describ adult variat induc mechan ventil arteri puls pressur puls oximet plethysmograph

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