Key result
The introduction of Pleth Variability Index monitoring did not significantly change the median fluid volumes infused during low to moderate risk surgery compared to standard care (1000 ml vs 1000 ml, p>0.05).
Why the study?
The introduction of a new technology has the potential to modify clinical practices, especially if easy to use, reliable, and non-invasive.
Does the introduction of Pleth Variability Index (PVI) alter fluid volumes infused during surgery in low to moderate risk surgery?
Observational (n=88)
Yes
Does the introduction of Pleth Variability Index (PVI) alter fluid volumes infused during surgery in low to moderate risk surgery?
The introduction of Pleth Variability Index monitoring without a specific implementation strategy did not change fluid management practices in low to moderate risk surgery.
Answers are grounded in this paper and cite their sources.
PVI introduction yielded no fluid management shift in this observational study; leaves open whether protocolized use improves outcomes in RCTs.
OBJECTIVES: The introduction of a new technology has the potential to modify clinical practices, especially if easy to use, reliable and non-invasive. This observational before/after multicenter service evaluation compares fluid management practices during surgery (with fluids volumes as primary outcome), and clinical outcomes (secondary outcomes) before and after the introduction of the Pleth Variability Index (PVI), a non-invasive fluid responsiveness monitoring. RESULTS: In five centers, 23 anesthesiologists participated during a 2-years period. Eighty-eight procedures were included. Median fluid volumes infused during surgery were similar before and after PVI introduction (respectively, 1000 ml [interquartile range 25-75 [750-1700] and 1000 ml [750-2000]). The follow-up was complete for 60 from these and outcomes were similar. No detectable change in the fluid management was observed after the introduction of a new technology in low to moderate risk surgery. These results suggest that the introduction of a new technology should be associated with an implementation strategy if it is intended to be associated with changes in clinical practice.
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Forget et al. (2021) conducted an observational in Low to moderate risk surgery (n=88). Pleth Variability Index (PVI) monitoring vs. Before PVI introduction was evaluated on Median fluid volume infused during surgery (ml) (p=>0.05). The introduction of Pleth Variability Index monitoring did not significantly change the median fluid volumes infused during low to moderate risk surgery compared to standard care (1000 ml vs 1000 ml, p>0.05).
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