Adequate fluid replacement reduced hypotension and hemodynamic instability after prone positioning. The Jackson spine table and longitudinal bolsters had minimal effects on cardiac function, and should be considered in patients with limited cardiac reserve.

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Six hundred eighty-eight consecutive patients with cardiac diseases or who were older than 70 yr of age, all of whom were undergoing noncardiac operations, were studied. Twenty-four preoperative risk factors were analyzed for the outcome of perioperative myocardial infarction (PMI) or cardiac death using stepwise logistic regression. Old age, emergency operation, angina, previous myocardial infarction, electrocardiographic signs of ischemia, type of surgical procedure, and hypokalemia were identified as individual factors useful in predicting outcome. Thirty-two patients (4.65%) developed PMI. Seven of these 32 patients (21.9%) and eight more patients without PMI--a total of 15 patients (2.2%)--died a cardiac death. Nonfatal but serious complications occurred in 23% of the patients. Patients undergoing emergency operations and patients with chronic stable angina, previous myocardial infarction, and electrocardiographic signs of ischemia were found to be at increased risk for PMI and cardiac death.

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