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Value of pleth variability index to guide fluid resuscitation in children with sepsis

Nan Xu, Lixing Qiao, Liping Yin, Han Li

Objectives: The present study was conducted to investigate the value of Pleth Variability Index (PVI) to guide fluid resuscitation in children with sepsis.

Materials and Methods: 60 patients with sepsis undergoing Early Goal-Directed Therapy (EGDT) were included as subjects of the present study, and randomly divided into two groups by drawing lots. There were 30 cases in each group. The observation group received PVI-guided fluid resuscitation while the control group received transthoracic echocardiography-guided fluid resuscitation. The mortality was recorded in two groups. The oxygen saturation of central vein (ScvO2), oxygenation index (PaO2/FiO2), APACHE II score and clearance rate of lactic acid were compared between two groups. The Intensive Care Unit (ICU) stay and total volume of fluid input were compared between two groups.

Results: Death occurred in 3 cases (10% mortality) in the observation group and in 7 cases in the control group (23.33% mortality). There was no significant difference in mortality between the two groups (χ2=1.920, P=0.166). The remaining patients attained the criteria for resuscitation. PaO2/FiO2 after treatment in the observation group was significantly lower than that before treatment and that in the control group (P<0.05). The APACHE II score was significantly lower than that before treatment and that in the control group (P<0.05). The clearance rate of lactic acid in the observation group was significantly higher than that in the control group (P<0.05). The duration of stay in ICU and the volume of fluid input in the observation group were significantly lower than those in the control group (P<0.05).

Conclusion: PVI-guided early fluid resuscitation can achieve satisfactory results, reduce complications and help to improve prognosis.