Disagreement between fourth generation FloTrac and LiDCOrapid measurements of cardiac output and stroke volume variation during laparoscopic colectomy

Nakasuji, Masato; Okutani, Aki; Miyata, Taeko; Imanaka, Norie; Tanaka, Masuji; Nakasuji, Kae; Nagai, Miwako

doi:10.1016/j.jclinane.2016.07.036

Cited by 12 publications

(9 citation statements)

References 30 publications

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“…In this study, we successfully employed the LiDCOrapid system for noninvasive assessment of the macrohemodynamic parameters (CO, SV, and SVR) during phenylephrine or norepinephrine infusion in CD. The LiD-COrapid system was previously validated for use in nonpregnant and pregnant populations [15][16][17]. This system enables continuous assessment of the SV based on noninvasive pulse contour analysis under spontaneous breathing, which provides a reliable hemodynamic trend [18,19].…”

Section: Discussionmentioning

confidence: 99%

Effects of continuous infusion of phenylephrine vs. norepinephrine on parturients and fetuses under LiDCOrapid monitoring: a randomized, double-blind, placebo-controlled study

et al. 2020

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Background Hypotension following spinal anesthesia (SA) during cesarean delivery (CD) occurs commonly and is related with maternal and fetal complications. Norepinephrine infusion is increasingly used for prevention of post-SA hypotension; however, its effects as compared to the traditional phenylephrine infusion remain unclear. This study aimed to compare the effects of phenylephrine and norepinephrine administered as continuous infusion during elective CD on maternal hemodynamic parameters and maternal and fetal outcomes. Methods This prospective, single-center, randomized, controlled study included 238 consecutive term parturients who underwent CD from February 2019 to October 2019. They were randomized to receive continuous infusion of 0.25 μg/kg/min phenylephrine, 0.05 μg/kg/min norepinephrine, or placebo. Hemodynamic monitoring was performed at 10 time points using LiDCOrapid. We analyzed umbilical vein (UV), umbilical artery (UA), and peripheral vein (PV) blood gas indexes and recorded intraoperative complications. Results In phenylephrine group, the systolic blood pressure (SBP) remain during the whole operation. Compared to the control group, phenylephrine, but not norepinephrine, significantly increased the systemic vascular resistance (SVR) to counteract the SA-induced vasodilatation, 3 min following norepinephrine/phenylephrine/LR administration (T4): 957.4 ± 590.3 vs 590.1 ± 273.7 (P < 0.000001); 5 min following norepinephrine/phenylephrine/LR administration (T5): 1104 ± 468.0 vs 789.4 ± 376.2 (P = 0.000002). at the time of incision (T6): 1084 ± 524.8 vs 825.2 ± 428.6 (P = 0.000188). Parturients in the phenylephrine group had significantly lower UV (1.91 ± 0.43) (P = 0.0003) and UA (2.05 ± 0.61) (P = 0.0038) lactate level compared to controls. Moreover, the UV pH value was higher in the phenylephrine than in the control group7.37 ± 0.03(P = 0.0013). Parturients had lower incidence of nausea, tachycardia, hypotension in phenylephrine group. Conclusions In this dataset, continuous phenylephrine infusion reduced the incidence of SA-induced hypotension, ameliorated SVR, while decreasing overall maternal complications. Phenylephrine infusions are considered the better choice during CD because of the significant benefit to the fetus. Trial registration Clinicaltrial.gov Registry, NCT03833895, Registered on 1 February 2019.

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Section: Discussionmentioning

confidence: 99%

Effects of continuous infusion of phenylephrine vs. norepinephrine on parturients and fetuses under LiDCOrapid monitoring: a randomized, double-blind, placebo-controlled study

et al. 2020

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“…The LiDCOrapid system was previously validated for use in non-pregnant and pregnant populations. [15][16][17] This system enables continuous assessment of the SV based on noninvasive pulse contour analysis under spontaneous breathing, which provides a reliable hemodynamic trend. 18,19 The typical hemodynamic response to SA in parturients adversely affects the SVR, a precise dynamic marker of preload responsiveness, and requires a compensatory antagonist.…”

Section: Discussionmentioning

confidence: 99%

Effects of continuous infusion of phenylephrine vs. norepinephrine on parturients and fetuses under LiDCOrapid monitoring: A randomized, double-blind, placebo-controlled study

Feng

Wang

Feng

et al. 2020

Preprint

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Background: Hypotension following spinal anesthesia (SA) during cesarean delivery (CD) occurs commonly and is related with maternal and fetal complications. Norepinephrine infusion is increasingly used for prevention of post-SA hypotension; however, its effects as compared to the traditional phenylephrine infusion remain unclear. This study aimed to compare the effects of phenylephrine and norepinephrine administered as continuous infusion during elective CD on maternal hemodynamic parameters and maternal and fetal outcomes.Methods: This prospective, single-center, randomized, controlled study included 238 consecutive term parturients who underwent CD from February 2019 to October 2019. They were randomized to receive continuous infusion of 0.25 μg/kg/min phenylephrine, 0.05 μg/kg/min norepinephrine, or placebo. Hemodynamic monitoring was performed at 10 time points using LiDCOrapid. We analyzed umbilical vein (UV), umbilical artery (UA), and peripheral vein (PV) blood gas indexes and recorded intraoperative complications.Results: In phenylephrine group, the systolic blood pressure (SBP) remain during the whole operation. Compared to the control group, phenylephrine, but not norepinephrine, significantly increased the systemic vascular resistance (SVR) to counteract the SA-induced vasodilatation, 3 min following norepinephrine/phenylephrine/LR administration (T4): 957.4±590.3 vs 590.1±273.7 (P<0.000001); 5 min following norepinephrine/phenylephrine/LR administration (T5): 1104±468.0 vs 789.4±376.2 (P=0.000002). at the time of incision (T6): 1084±524.8 vs 825.2± 428.6 (P=0.000188). Parturients in the phenylephrine group had significantly lower UV (1.91±0.43) (P=0.0003) and UA (2.05±0.61) (P=0.0038) lactate level compared to controls. Moreover, the UV pH value was higher in the phenylephrine than in the control group7.37±0.03(P=0.0013). Parturients had lower incidence of nausea, tachycardia, hypotension in phenylephrine group.Conclusions: In this dataset, continuous phenylephrine infusion reduced the incidence of SA-induced hypotension, ameliorated SVR, while decreasing overall maternal complications. Phenylephrine infusions are considered the better choice during CD because of the significant benefit to the fetus.Trial registration: Clinicaltrial.gov Registry, NCT03833895, Registered on 1 February 2019.

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“…Dynamic monitoring indices guide fluid replacement [ 5 ] but are not very reliable in the context of minimally invasive surgery. [ 6 7 ] This obligates a fluid management based upon haemodynamic profile, urine output and metabolic parameters such as lactate, which is an early indicator of tissue hypoperfusion. [ 8 ] The restrictive versus liberal fluid therapy in major abdominal surgery (RELIEF) trial [ 9 ] while comparing a restrictive versus liberal fluid administration strategy has shown increased risk of renal failure, renal replacement therapy and surgical site infection in the restrictive group.…”

Section: Discussionmentioning

confidence: 99%

Effect of liberal versus restrictive fluid therapy on intraoperative lactate levels in robot- assisted colorectal surgery

Kumar

Sandhya

et al. 2020

Indian J Anaesth

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Background and Aims: Minimally invasive and robotic surgeries need lesser fluid replacement but the role of restricted fluids in robotic surgeries other than prostatic surgeries has not been clearly defined. Our primary aim was to evaluate the effects of a restrictive fluid regimen versus a liberal policy on intra-operative lactate in robotic colorectal surgery. Secondary outcomes were need for vasopressors, extubation on table, post-operative renal functions and length of ICU (LOICU) stay. Methods: American society of anaesthesiologists (ASA) physical status I–II patients scheduled for robot-assisted colorectal surgery were randomised into one of two groups, receiving either 2 mL/kg/h (Group R) or 4mL/kg/h, (group L). Fluid boluses of 250 ml were administered if mean arterial pressure (MAP) <65 mmHg or urine output <0.5 ml/kg/h. Norepinephrine was added for the blood pressure after 2 fluid boluses. Surgical field was assessed by modified Boezaart's scale and surgeon satisfaction by Likert scale. Results: Demographics and baseline renal functions were comparable. Adjusted intra-operative lactate at 2 h, 4 h, and 6 h and need for noradrenaline and post-operative creatinine were similar. One patient in the group L was ventilated due to hypothermia. The field was better at the 4 h in group R and comparable at other time points. The LOICU stay was longer in Group L. Conclusion: The use of restrictive fluid strategy of 2 mL/kg/h (group R) does not increase lactate levels or creatinine, improves surgical field at 4 h and shortens ICU stay in comparison to a liberal 4 mL/kg/h (group L) in robotic colorectal surgery.

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Disagreement between fourth generation FloTrac and LiDCOrapid measurements of cardiac output and stroke volume variation during laparoscopic colectomy

Cited by 12 publications

References 30 publications

Effects of continuous infusion of phenylephrine vs. norepinephrine on parturients and fetuses under LiDCOrapid monitoring: a randomized, double-blind, placebo-controlled study

Effects of continuous infusion of phenylephrine vs. norepinephrine on parturients and fetuses under LiDCOrapid monitoring: a randomized, double-blind, placebo-controlled study

Effects of continuous infusion of phenylephrine vs. norepinephrine on parturients and fetuses under LiDCOrapid monitoring: A randomized, double-blind, placebo-controlled study

Effect of liberal versus restrictive fluid therapy on intraoperative lactate levels in robot- assisted colorectal surgery

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