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A Journal on Anesthesiology, Resuscitation, Analgesia and Intensive Care
Minerva Anestesiologica 2016 October;82(10):1115-21
A dynamic view of dynamic indices
Marc O. FISCHER 1, 2, Pierre G. GUINOT 3, 4, Matthieu BIAIS 5, 6, Yazine MAHJOUB 3, 4, Jihad MALLAT 7, Emmanuel LORNE 3, 4 on behalf of the French Hemodynamic Team (FHT) ✉
1 Pôle Réanimations Anesthésie SAMU/SMUR, CHU de Caen, Caen, France; 2 EA 4650, Université Caen Normandie, Caen, France; 3 Department of Anesthesiology and Critical Care, Amiens University Medical Center, Amiens, France; 4 INSERM ERI12, Jules Verne University of Picardy, Amiens, France; 5 Department of Anesthesiology and Critical Care Medicine III, Bordeaux University Medical Center, Bordeaux, France; 6 “Adaptation Cardiovasculaire à l’Ischémie” Research Unit, INSERM U1034, University of Bordeaux, Pessac, France; 7 Department of Anesthesiology and Critical Care Medicine, Centre Hospitalier du Dr Schaffner, Lens, France
Dynamic indices (based on cardiopulmonary interactions in mechanically ventilated patients in sinus rhythm) have been developed as simple tools for predicting fluid responsiveness in the absence of cardiac output monitoring. Although the earliest dynamic indices relied on the invasive measurement of pulse pressure variations or stroke volume variations, the most recently developed indices are based on non-invasive photoplethysmography. However, a number of confounding factors have been found which decrease the clinical value of these indices. The present experts’ opinion explains why changes in dynamic indices during hemodynamic maneuvers might be an interesting alternative to using them accurately at bedside.