Masimo found a study published in the Journal of Applied Physiology in which Dr. Marina García-de-Acilu and colleagues at the Vall d’Hebron University Hospital in Barcelona evaluated the utility of Masimo PVi as a non-invasive method of predicting preload responsiveness in patients treated with nasal high-flow (NHF) therapy.
The study reveals that PVi can be used in the clinical decision-making process in critically ill patients treated with NHF, providing adequate resuscitation volume.
The researchers wanted to see the potential convenience of a non-invasive method of predicting fluid responsiveness in NHF patients. To do so, they compared PVi to reference measurements—stroke volume (SV) and cardiac output (CO)—in 20 adult ICU patients with acute respiratory failure (ARF) supported by NHF (flow ≥ 30 L/min). PVi was measured using a Masimo Radical-7 Pulse CO-Oximeter with a pulse oximetry sensor attached to the finger.
The researchers found that preload responders showed higher baseline PVi values and ΔPVi after PLR. PVi and ΔPVi after PLR showed “excellent diagnostic accuracy for predicting preload responsiveness.” Additionally, the researchers found that ΔPVi after PLR and after fluid challenge were strongly correlated (r = 0.84, p < 0.001).
The researchers concluded: “This physiological study suggests that PVi might predict preload responsiveness in hypoxemic ARF patients treated with NHF. Further research should focus on validating these results and analyze whether PVi-guided fluid administration can improve outcomes in NHF patients.”
The accuracy of PVi in predicting fluid responsiveness is variable and influenced by numerous patient, procedure, and device-related factors. PVi measures the variation in the plethysmography amplitude but does not provide stroke volume measurement or cardiac output. Fluid management decisions should be based on a complete assessment of the patient’s condition and should not be based solely on PVi.
