Interchangeability Between Pleth Variability Index and Internal Jugular Vein Variability Index During Laparoscopic Living Donor Nephrectomy: A Prospective Observational Concordance Study
Year: 2026
Type: preprint
Study design: Observational Study
Abstract: Background Objective This study aimed to evaluate whether PVi and IJV-VI demonstrate sufficient agreement and trending ability to support their clinical interchangeability during laparoscopic living donor nephrectomy. Methods A prospective observational concordance study was conducted in adult patients undergoing elective laparoscopic living donor nephrectomy under mechanical ventilation. Simultaneous paired measurements of PVi and IJV-VI were obtained every 15 minutes during surgery. Agreement between methods was assessed using repeated-measures Bland–Altman analysis. Trending ability was evaluated using polar plot and four-quadrant plot analyses. Results Thirty-six patients were included, providing 366 paired intraoperative measurements. Bland–Altman analysis demonstrated a small overall bias of 0.06% (95%CI −0.21 to 0.39), with wide 95% limits of agreement ranging from −5.10% to 5.22% and a global percentage error of 55.96% (95% CI 37.81–74.17). Polar plot analysis showed poor trending ability, with an angular bias of 14.2°, angular dispersion of 117°, and only 34.5% of vectors within the clinically acceptable ±30° zone. Four-quadrant analysis demonstrated an overall concordance rate of 84.7% after applying a central exclusion zone. Conclusion Although PVi and IJV-VI demonstrated a strong positive association during laparoscopic living donor nephrectomy, agreement and trending ability between methods were limited. Main Points PVi and IJV-VI showed a strong positive association, but this did not translate into adequate agreement. Repeated-measures Bland–Altman analysis demonstrated minimal bias but wide limits of agreement and a high percentage error. Trending ability between both methods was poor, particularly in polar plot analysis. PVi and IJV-VI should not be considered clinically interchangeable during laparoscopic living donor nephrectomy.
Source: medRxiv
Authors: Escarramán Martinez Diego, Sanchez Brito Sebastian, Pérez Lozano Eduardo, Escorza Molina Carla Adelina, Noriega Salas Lorena, Candelaria Olguín Ricardo, Perez Nieto Orlando Rubén, Guerrero Gutierrez Manuel Alberto, Solis Perez Gerardo Alberto, Ignacio Rodriguez Guevara, Galeana Gonzalez Liliana Catalina
Language: English
Subfield: Surgery
Field: Medicine
Domain: Health Sciences
Open Access status: green
OpenAlex ID: W7213317689