Evaluation Of Pleth Variability Index For Prediction Of Hypotension During Anesthesia Induction In High Risk Patients

Objective:We design this prospective clinical research to evaluate the feasibility of PVI as a predictor of hypotension during anesthesia induction in the moderate-high risk cardiovascular patients.Method:19moderate-high risk cardiovascular patients were included whose PI, PVI and systolic pressure (SP), diastolic pressure (DP), mean arterial pressure (MAP), heart rate (HR) were consecutively recorded pre-and post-anesthesia induction before intubation. We analysis the relationship between PVI and other variables, compare blood pressure and heart rate pre-and post-anesthesia induction and evaluate the feasibility of PVI, CVP, risk factors, age as predictors of hypotension during anesthesia induction by stepwise multiple linear regression and receiver operating curve.Result:Among the21patients,2were excluded. Pre-induction PVI has a moderate negative correlation with PI and CVP (P<0.05), whose Pearson coefficients are-0.34and-0.32(P<0.05), respectively, while it does not relate to risk factors, age or ASA classification. After anesthesia induction, SP, DP, MAP, HR decrease signigicantly (P<0.01), while PI and PVI are unchangeable. The decrease of SP partly ascribes to age and risk factors (P<0.01), and the decrease of MAP partly ascribes to age and PVI (P<0.01), while no variable contributes to decrease of DP and HR. Age could predict25%decrease of MAP with area under the curve (AUC)of0.86and threthold of52(P<0.01), whose sensitivity and specifity is79%and87%respectively. The AUC of PVI is0.45with lower specifity and sensitivity.Conclusion:Pre-induction PVI has a moderate negative correlation with PI and CVP in the moderate-high risk cardiovascular patients. Age is an liable predictor of hypotension during anesthesia induction, while PVI is not recommended as a result of low sensitivity and specifity in patients with cardiovascular risk factors.