Lung recruitment in morbidly obese patients could be effectively monitored by combining noninvasive pulse oximetry and VCap. SpO2, the elimination of CO2, and Bohr's dead space detected the individual's opening and closing pressures.
Objective: To evaluate the lower vena cava Collapse Index (CI) as a predictor parameter of hypotensive episodes after general anesthesia induction in ASA I and II patients who were scheduled for elective surgery. Materials and Methods: A prospective, observational and simple blind study was designed. A sample of 80 patients was recruited. In the preoperative stage, they underwent protocolarized sedation and CI was obtained. Prior to induction, the baseline values of heart rate, non-invasive mean arterial pressure and continuous electrocardiographic tracing in DII were noted. In the post-orotracheal intubation stage, the aforementioned hemodynamic monitoring variables were recorded manually for 10 minutes. Results: The data of 78 individuals are presented. After anesthetic induction, 8 (10.3%) patients developed hypotension. The adjustment of the univariate logistic regression model for CI shows a good diagnostic capacity, with the area under the ROC curve equal to 0.76. The chance of presenting hypotension is increased by 62% by increasing the CI by 5 points (p = 0.003). Regarding the negative predictive value, we found that with values corresponding to the cutoff points between 39% and 46%, a probability of at least 93.1% of not presenting hypotension was obtained. The optimal cutoff point of the CI to predict hypotension is estimated at 43%, with a sensitivity of 62.5% and a specificity of 92.9%. Conclusion: A lower IC was associated with a lower probability of developing intraoperative hypotension. The use of this tool could be useful to anticipate which patients will be prone to intra-surgical hypotension.
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