Abilities of Pulse Pressure Variations and Stroke Volume Variations to Predict Fluid Responsiveness in Prone Position During Scoliosis Surgery

Biais, Matthieu; Bernard, O.; Ha, Jones; Degryse, C.; Sztark, F.

doi:10.1097/01.sa.0000391588.14003.bd

Cited by 15 publications

(16 citation statements)

References 8 publications

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“…25 Systolic pressure variation may also be used for fluid status monitoring as it increases during hypovolemia. 27 High-risk patients should be identified so that positioning can be optimized, and adhesive defibrillator pads can be applied prior to surgery.…”

Section: Recommendationsmentioning

confidence: 99%

The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines

Kwee

Rozen

2015

International Surgery

215

162

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Surgery in the prone position is often a necessity when access to posterior anatomic structures is required. However, many complications are known to be associated with this type of surgery, as physiologic changes occur with increased pressure to anterior structures. While several studies have discussed postoperative vision loss, much fewer studies with lower levels of evidence have addressed other complications. A systematic literature review was conducted using 2 different databases, and 53 papers were regarded as appropriate for inclusion. Qualitative and quantitative analysis was performed. Thirteen complications were identified. Postoperative vision loss and cardiovascular complications, including hypovolemia and cardiac arrest, had the most number of studies and highest level of evidence. Careful planning for optimal positioning, padding, timing, as well as increased vigilance are evidence-based recommendations where operative prone positioning is required.

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Section: Recommendationsmentioning

confidence: 99%

The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines

Kwee

Rozen

2015

International Surgery

215

162

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“…Les dispositifs de monitorage non invasif du débit cardiaque qui se fondent sur le débit systolique ou sur la variation de la pression différentielle ont été validés pour prédire la réponse au remplissage en position ventrale. 20 Quant à l'ETO en position ventrale, son utilité est diminuée par les mouvements restreints de la sonde et les fenêtres échocardiographiques limitées, ainsi que par des inquiétudes reliées au risque de lésions de la langue et du pharynx lors d'interventions prolongées. Il pourrait être extrêmement difficile d'insérer une sonde d'ETO après le positionnement du patient en position ventrale, particulièrement si sa tête est maintenue dans un clameau crânien Mayfield.…”

Section: Induction / Prise En Charge Des Voies Aériennesunclassified

“…Noninvasive cardiac output monitoring devices based on stroke volume or pulse pressure variation have been validated to predict fluid responsiveness in the prone position. 20 The use of TEE in the prone position has been hindered by limited probe movement and echocardiographic views, as well as cumbersome ergonomics, and concerns about tongue and oropharyngeal pressure injuries in prolonged procedures. It may be extremely difficult to insert a TEE probe after the patient has been turned into the prone position, especially if the head is fixed in a Mayfield clamp.…”

Section: Hemodynamic Managementmentioning

confidence: 99%

An update on the prone position: Continuing Professional Development

Chui

Craen

2016

Can J Anesth/J Can Anesth

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Purpose The purpose of this Continuing Professional Development module is to provide information needed to prepare for and clinically manage a patient in the prone position. Principal findings Prone positioning is required for surgical procedures that involve the posterior aspect of a patient. We searched MEDLINE Ò and EMBASE TM from January 2000 to January 2015 for literature related to the prone position and retrieved only original articles in English. We reviewed the advantages and disadvantages of various equipment used in prone positioning, the physiological changes associated with prone positioning, and the complications that can occur. We also reviewed strategies for the safe conduct and management of position-related complications. Conclusion Increased age, elevated body mass index, the presence of comorbidities, and long duration of surgery appear to be the most important risk factors for complications associated with prone positioning. We recommend a structured team approach and careful selection of equipment tailored to the patient and surgery. The systematic use of checklists is recommended to guide operating room teams and to reduce prone position-related complications. Anesthesiologists should be prepared to manage major intraoperative emergencies (e.g., accidental extubation) and anticipate postoperative complications (e.g., airway edema and visual loss).

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“…El paciente quirúrgico puede precisar fluidos para corregir diversas situaciones clínicas: restauración de la volemia ante pérdidas hemáticas; fluidoterapia de mantenimiento después de la cirugía; pérdidas que se producen por los tractos gastrointestinal o urinario, o pérdidas insensibles elevadas por fiebre y quemaduras 5 ; la redistribución de fluidos puede desarrollar edema tisular por exceso de agua y sodio y puede haber secuestro de líquido en el tracto gastrointestinal o en la cavidad torácica y/o peritoneal 18 . Además, en el paciente quirúrgico pueden presentarse cambios hemodinámicos inducidos por la anestesia, como la vasoparesia y venodilatación en respuesta a bloqueo neuroaxial 19 y cambios hemodinámicos inducidos por factores quirúrgicos, como son la colocación del paciente 20 o la aplicación de presión en cavidades corporales, como en el neumoperitoneo, para facilitar la cirugía laparoscópica, que inducen una situación de déficit funcional de volumen.…”

Section: Fluidoterapia Perioperatoriaunclassified

Guía de práctica clínica para la elección del fluido de restauración volémica perioperatoria en los pacientes adultos intervenidos de cirugía no cardiaca

Basora¹,

Colomina

Moral

et al. 2016

Revista Española de Anestesiología y Reanimación

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Cómo citar este artículo: Basora M, et al. Guía de práctica clínica para la elección del fluido de restauración volé-mica perioperatoria en los pacientes adultos intervenidos de cirugía no cardiaca. Resumen Esta Guía de Práctica Clínica responde a preguntas clínicas sobre seguridad en la elección de fluido (cristaloide, coloide o Hidroxietilalmidón 130) en pacientes que precisan restauración volémica en el periodo perioperatorio de cirugía no cardiaca. A partir del resumen de la evidencia, se elaboraron las recomendaciones siguiendo la metodología GRADE. En esta población se sugiere la fluidoterapia basada en la administración de cristaloides, (recomendación débil, calidad de la evidencia baja). En las situaciones en las que la restauración volémica no se alcance sólo con cristaloides, se sugiere utilizar coloides sintéticos (Hidroxietilalmidón 130 o gelatina fluida modificada) en lugar de Albúmina 5% (recomendación débil, calidad de la evidencia baja). La elección y dosificación de coloide deberán basarse en las características del producto, comorbilidad del paciente y experiencia del anestesiólogo.

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Abilities of Pulse Pressure Variations and Stroke Volume Variations to Predict Fluid Responsiveness in Prone Position During Scoliosis Surgery

Cited by 15 publications

References 8 publications

The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines

The Prone Position During Surgery and its Complications: A Systematic Review and Evidence-Based Guidelines

An update on the prone position: Continuing Professional Development

Guía de práctica clínica para la elección del fluido de restauración volémica perioperatoria en los pacientes adultos intervenidos de cirugía no cardiaca

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