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The pulse oximetry plethysmographic curve revisited

Bendjelid, Karim

Current Opinion in Critical Care: June 2008 - Volume 14 - Issue 3 - p 348–353
doi: 10.1097/MCC.0b013e3282fb2dc9
Cardiopulmonary monitoring: Edited by Christian Richard

Purpose of review To evaluate the recent literature on the utility of the pulse oximetry plethysmographic curve to assess macrocirculation and microcirculation monitoring in intensive care patients.

Recent findings In patients with sinus rhythm who are hypotensive, deeply sedated, mechanically ventilated, critically ill and in the operation room, plethysmographic pulse variation related to mechanical breath is a recent noninvasive indicator of preload dependency.

Summary A growing number of recent clinical studies demonstrated that plethysmographic dynamic indices are useful methods to assess fluid responsiveness. Any alternating signal processing of the raw data curves, however, may be detrimental for this purpose, as significant clinically relevant information could be lost after perpetual adjustment of filtering. Hence, time will tell if the pulse oximetry plethysmographic curve will succeed other methods as a noninvasive approach to monitor haemodynamics of critically ill patients.

Department of Anesthesiology, Pharmacology, and Intensive Care, Geneva University Hospitals, Geneva, Switzerland

Correspondence to Dr Karim Bendjelid, MD, MS, Médecin adjoint agrégé, Department of Anesthesiology, Pharmacology, and Intensive Care, University Hospitals of Geneva, Geneva CH-1211, Switzerland Tel: +41 22 382 74 60; fax: +41 22 382 74 70; e-mail: karim.bendjelid@hcuge.ch

© 2008 Lippincott Williams & Wilkins, Inc.