NONINVASIVE MONITORING OF CRITICALLY ILL CHILD

nmcickapak

PLETH VARIABILITY INDEX (PVI) MONITORING IN CRITICALLY ILL CHILD

Emel Berksoy1
Şefika Bardak2

1Health Sciences University, İzmi̇r Tepeci̇k Education and Research Hospital, Department of Pediatric Emergency, İzmir, Türkiye
2İzmir City Hospital, Department of Pediatric Emergency, İzmir, Türkiye

Berksoy E, Bardak Ş. Pleth Variability Index (PVI) Monitoring in Critically Ill Child. Bal A, ed. Noninvasive Monitoring of Critically Ill Child. 1st ed. Ankara: Türkiye Klinikleri; 2025. p.23-30.

ABSTRACT

Pleth Variability Index (PVI) is a non-invasive monitoring method used to evaluate the hemodynamic status of critically ill pediatric patients. Measurement is performed using a pulse oximeter probe placed on the fingertip, requiring no specialized experience and offering ease of application. It reflects volume changes in the vascular bed during respiration. Currently, PVI is employed in emergency departments, intensive care units, and operating rooms. Monitoring with PVI has been found to reliably predict fluid responsiveness in patients under mechanical ventilation with regular respiratory cycles. In periop- erative goal-directed fluid management, PVI has been reported to guide decision-making processes for fluid administration. Furthermore, it may contribute to circulatory assessment in spontaneously breathing patients and various patient groups. Among pediatric patients, its ability to reduce the need for invasive methods is a notable advantage. However, factors such as respiratory patterns, perfusion changes, vasoactive drugs, and age significantly influence PVI values, posing important limitations. Thus, it is crucial to interpret PVI in conjunction with other clinical findings and hemodynamic param- eters. For clinicians seeking a simple and effective method to optimize fluid management in pediatric patients, PVI is considered a promising option

Keywords: Child; Critically Ill; Fluid therapy; Hemodynamic monitoring; Plethysmography

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