Investigation of the PVI (pleth variability index) controlled goal directed fluid therapy on tissue perfusion in patient undergoing sleeve gastrectomy

ABSTRACT INVESTIGATION OF THE PVI (PLETH VARIABILITY INDEX) CONTROLLED GOAL DIRECTED FLUID THERAPY ON TISSUE PERFUSION IN PATIENT UNDERGOING SLEEVE GASTRECTOMY In this study, the aim is to investigate the effects of PVI controlled targeted fluid therapy on tissue perfusion in patients who underwent laparoscopic sleeve gastrectomy. Plasma lactate level was evaluated retrospectively to assess the effect of these fluid treatments on tissue perfusion. In our study, group treated with PVI controlled targeted fluid therapy was defined as group I, and group with standard fluid therapy was designated as Group II. In group I, fluid therapy was applied with a PVI ratio of 14%. In group II, fluid therapy was applied as standard 4-6 mL/kg/h. In case of hypotension (<65 mmHg) or in case of bleeding, bolus colloid was applied in both groups. In both groups, arterial blood samples were taken at 6, 12, 18, 24, 36, 48 hours of skin incision every hour and post-operatively during surgery. When the lactate levels between the groups were compared, intraoperative 60th min (1,25 ± 0,48-1,57 ± 0,51) and post-operative 48th hour (0,73 ± 0,27- 0.91 ± 0.36) were found to be significantly lower in Group I. The mean crystalloid volume applied to group I was 734,33 ± 85,20 mL, whereas it was 1214,7 ± 231,43 mL applied to Group II and this difference was significant. The total volume of fluid administered to group I was 1242,667 ± 283,073 mL and group II was 1739,667 ± 303,888 mL, and this difference was significant. In conclusion, we concluded that the use of targeted fluid therapy improves tissue perfusion in our study, and further studies are needed to examine the effects of PVI and targeted fluid therapy on tissue perfusion in patients undergoing the same operation. Key Words: Peri-operative targeted fluid therapy, PVI, Bariatric surgery, Lactate