Researchers found that fluid therapy guided by non-invasive and continuous PVi can reduce cardiopulmonary complications and infusion.

Masimo (NASDAQ: MASI) today announced a publication in Perioperative Medicine According to the results of prospective randomized studies, Dr. Yu Wang and his colleagues from medical institutions in Shenzhen, Shaoguan and Guangzhou, China evaluated non-invasive and continuous Masimo PVi^® as a component of target-oriented liquid therapy (GDFT) by comparing with traditional liquid therapy. Use of intraoperative infusion during gastrointestinal (GI) surgery in elderly patients. The researchers found that the incidence of cardiopulmonary complications in patients in the PVi group was significantly lower (8.4% and 19.2%), and the total amount of infusion was also significantly reduced (the median amount of infusion was 2075 ml and 2500 ml). ¹

"In elderly patients undergoing gastrointestinal surgery, GDFT based on simple and non-invasive PVi did not reduce the occurrence of postoperative complex complications, but the incidence of cardiopulmonary complications is lower than usual fluid management."

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The researchers noted the special value of optimizing fluid management during gastrointestinal surgery, especially for elderly patients, because of the high incidence of postoperative complications and frequent fluid deficiency (due to preoperative fasting, intestinal preparation and intraoperative fluid loss). The researchers tried to determine whether GDFT using Masimo PVi could improve the results of this difficult surgical scene. PVi (i.e. pulse oxygen volume variation index) is a measure of the change of blood flow perfusion index during the respiratory cycle. Compared with liquid reactivity measurement methods based on arterial catheters (such as per beat output change [SVV] and pulse pressure change [PPV]), the advantage of this measurement method is through non-invasive Masim. o Rainbow SET^® pulse oximeter and pulse CO oximeter are obtained. PVi is a non-invasive dynamic indicator of liquid reactivity in the group of adult patients with specific mechanical ventilation. The researchers pointed out that PVi has shown similar effects to invasive fluid assessment methods (such as PPV and SVV) in various operations. ²

The researchers recruited patients of no less than 65 who were planned to undergo elective gastrointestinal surgery at two university hospitals from November 2017 to December 2020. Patients were randomly assigned to the GDFT group (n = 107) or the traditional liquid therapy (CFT) group (n = 104). In The GDFT Group, The PVi That Guides Liquid Treatment Is Obtained By The Photoelectric Volume Tracing Waveform Measured By The Rainbow Set^® Pulse CO Hemothyroidimeter Sensor At The Fingertip. The evaluation and comparison results of the two groups are: 30 days of postoperative compound complications; 30-day cardiopulmonary complications (pneumonia, atelectasis, pulmonary edema, arrhythmia and acute myocardial infarction); the time of the first gastrointestinal flatulence; postoperative nausea and vomiting; infection, including anastomosis leakage rate; and postoperative hospitalization time.

The researchers found that the incidence of cardiopulmonary complications and the total amount of intraoperative infusion in the GDFT (PVi) group were statistically significantly reduced, as shown in the table below. Although the PVi group tends to have a shorter hospital stay and a low anastomotic leakage rate, there is no statistically significant difference between these results and other results.

The researchers concluded: "In elderly patients undergoing gastrointestinal surgery, GDFT based on simple and non-invasive PVi did not reduce the occurrence of postoperative complex complications, but compared with normal fluid management, the incidence of cardiopulmonary complications is lower."

Joe Kiani, founder and CEO of Masimo, said: "We launched PVi in 2007. This is the first and only non-invasive method to measure liquid reactivity through the pulse oximeter. Using our pulse oximeter, the cost is only a small part of the invasive method. And it will not cause the risk of invasive operation to the patient. Since then, PVi has made great contributions to patient care, and its practical value as a liquid reactivity index has been proven in more than 100 independent and published studies. ² This latest study further proves that PVi can be used to help clinicians manage patients' body fluid levels without using invasive catheters.

PVi has been approved by FDA 510(k) in the United States as a non-invasive dynamic indicator of liquid reactivity in the group of adult patients with specific mechanical ventilation. The accuracy of PVi predicting liquid reactivity is variable and is affected by many patient, surgical and equipment-related factors. PVi measures the change of volumetric amplitude, but does not provide measurement of per beat or cardiac output. Liquid management decisions should be based on a complete assessment of the patient's condition, not just on PVi.