The predictive value of the Pleth Variability Index on fluid responsiveness in spontaneously breathing anaesthetized children - a prospective observational study.

BACKGROUND In children the preoperative hydration status is an important part of the overall clinical assessment. The assumed preoperative fluid deficit is often routinely replaced during induction without knowing the child's actual fluid status. AIM We investigated the predictive value of the Pleth Variability Index as a measure of fluid responsiveness in spontaneously breathing anesthetized children. METHODS Pleth Variability Index, stroke volume and cardiac index, measured by electrovelocimetry, mean blood pressure and heart rate were recorded during anesthesia induction in 50 pediatric patients 15%(Positive predictive value2.71 (95% CI1.4 to 5.2)).Only in fluid responders the Pleth Variability Indexdecreased during passive leg raising, while stroke volume increased. CONCLUSIONS The Pleth Variability Index may be of additional value topredict fluid responsiveness in spontaneously breathing anesthetized children. A significant overlap in baseline Pleth Variability Index values between fluid responsive and non fluid responsive patients does not allow a reliable recommendation as to acut-off value.