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.