Conclusion
In obese people, pneumoperitonium can lead to inaccuracies in monitoring
PVI and SpHb. Although these two parameters are very valuable in
intraoperative follow-up, they should be used carefully during
laparoscopic procedures in obese patients. If these parameters (PVI and
SpHb) are considered to be used in bariatric surgeries, this information
should be considered.
Key words : Laparoscopic cholecystectomy; pneumoperitoneum;
pleth variability index; total hemoglobin; obesity
One of the dynamic parameters used to predict fluid response in
mechanically ventilated patients is the platelet variability index
(PVI), which is obtained by continuous and automatic calculation of
pulse oximetry plethysmographic waveform variability during the
respiratory cycle. Factors such as arrhythmia, hypothermia, spontaneous
respiratory activity, vasoactive drug use, and impaired peripheral
perfusion limit the presence of PVI and SpHb monitoring. The ability of
these dynamic parameters to predict fluid response and blood loss may be
affected by respiratory, hemodynamic, and physical changes that cause
changes in intrathoracic pressure.
In the obese, pneumoperitoneum can lead to errors in PVI and SpHb
monitoring. Although these two parameters are very valuable in
intraoperative follow-up, they should be used with caution during
laparoscopic procedures in obese patients. This information should be
considered if these parameters (PVI and SpHb) are considered to be used
in bariatric surgeries, which is the most frequently performed surgical
procedure with the combination of obesity and pneumoperitoneum. This is
the first study with standardized patient groups on the reliability of
PVI and SpHb in obesity and pneumoperitoneum.