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Each year, at least 310 million patients undergo major surgery worldwide, procedures that involve the administration of intravenous fluids Intraoperative hemodynamic management is challenging because precise assessment of the adequacy of the intravascular volume is difficult during surgery Achieving optimal IV fluid therapy should improve perioperative outcomes and is a key component in many perioperative guidelines and pathways. IV fluids, like other medications, should only be given in well-defined protocols according to individual needs More recently, so called dynamic predictors of fluid responsiveness such as pulse pressure variation (PPV), stroke volume variation (SVV), or Perfusion Index (PI) have been used in intraoperative goal directed fluid therapy ( GDT) hemodynamic protocols
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| Measure | Description | Time Frame |
|---|---|---|
| Comparison between perfusion index and pulse pressure variability for prediction of intravascular volume during major abdominal surgeries | Comparing 2 percentage; Perfusion index and pulse pressure variability in assessment of intravascular volume and fluid responsiveness of the patient during major abdominal surgeries PI is a ratio of pulsatile light absorption to continuous light absorption, denoted as AC/DC. Normal PI values can vary widely, ranging from less than 1% to greater than 10%. The pulse pressure variation (PPV) is a percentage measure of the respiratory effect on the variation of systemic arterial blood pressure in patients receiving full mechanical ventilation The PI will be monitored by attaching a sensor to the patient's finger (Ultralife Pulse Oximeter JPD-500D). The PPV will be measured using an arterial line in radial artery Patients will receive maintenance and deficit fluids then measuring perfusion index (PI) and pulse pressure variability (PPV) which the cut off value of is higher than 13% for more than 5 min, values of PI in percentage in corresponding time will be measured and recorded | 6 months |
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Inclusion Criteria:
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Inclusion Criteria:
ASA 1, 2 Age: 18-65 Undergoing major abdominal surgeries Mechanically ventilated and sedated patients
Exclusion Criteria:
Chronic cardiac arrhythmias High doses of vasopressors Altered myocardial function (left ventricular ejection fraction < 50%) Peripheral vascular disease Severe respiratory disease Pulmonary or intra-abdominal hypertension Open chest
Exclusion Criteria:
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adult patients under general anaesthesia scheduled for major abdominal surgeries between the period from January 2025 to june 2025 will be observed for comparison between PI and PPV in detecting intravascular volume.
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| Name | Affiliation | Role |
|---|---|---|
| Randa Ali Shokry | Faculty of medicine AinShamsU | Study Chair |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ain Shams University | Cairo | Egypt | 1111 | Egypt |
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