Abstract
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Can Pleth Variability Index Levels in Patients with Upper Gastrointestinal Bleeding Predict the Requirement for Transfusion
by Hüseyin T. Yanik, Metin Yadigaroğlu, Umut E. Aykut, Metin Ocak, Levent Gülbüz, Şakir H. Aksu, Murat Yücel, Murat Güzel
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Background: Pleth variability index (PVI) is a dynamic and non-invasive form of hemodynamic monitoring. Studies have shown that PVI is valuable in assessing the patient's fluid status and determining whether fluid response can be achieved in critically ill patients.
In this study, we aimed to determine the value of PVI levels measured in patients with gastrointestinal tract (GI) bleeding admitted to the emergency department in predicting the possible need for blood product replacement.
Methods: This study was planned as a single-center, prospective observational study. Patients over 18 years of age who were diagnosed with GI bleeding in the emergency department and who underwent endoscopy were included in the study. Sociodemographic characteristics, PVI levels, and laboratory results were recorded. The relationship between PVI levels, laboratory results, and blood product replacement was analyzed.
Results: The mean age of the patients included in the study was 68.2 ± 15.02 years, and 61% (n = 61) were male. The median hemoglobin level of patients who received blood product replacement was 7.3 (3.6 - 14.8). The median PVI level was 24.5 (8 - 81) in patients with blood product replacement (p < 0.020). It was determined that PVI levels measured ≥ 28 could predict the need for replacement in patients with GI hemorrhage.
Conclusions: This is the first study to determine PVI levels in patients with GI bleeding. According to the results of this study, PVI levels measured at the time of presentation to the emergency department may be a predictive parameter of blood product replacement requirements in patients with GI bleeding.
DOI: 10.7754/Clin.Lab.2025.250805
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