Gradient between dorsalis pedis and radial arterial blood pressures during sevoflurane anaesthesia

Chen, Yan; Sun, James J.; Wang, Enqin; Zhu, Yuan; Li, Yongshuai; Lü, Kun

doi:10.1097/eja.0000000000000295

Cited by 8 publications

(4 citation statements)

References 25 publications

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“…The Bland–Altman method does not specify sample size as it is not a conventional statistical test, 18 and there are no requirements regarding patient or measurement numbers for studies in which repeated measurements are compared. 19 Therefore, we used the methods reported in previous studies 17,20 and analyzed over 150 paired measurements, which was considered sufficient for adequate interpretation of the study findings.…”

Section: Methodsmentioning

confidence: 99%

“…The mean BP value over five consecutive beats was recorded to reduce the effects of respiration. 17 The primary outcome was the assessment of the agreement of SAP, DAP and MAP values between the dRA and RA approaches using Bland-Altman analysis. The secondary outcome was the tracking ability of each hemodynamic variable compared between the two approaches.…”

Section: Clinical and Perioperative Variablesmentioning

confidence: 99%

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Agreement between distal and forearm radial arterial pressures in patients undergoing prone spinal surgery: a prospective, self-controlled, observational study

Xiong,

Xu,

Hui

et al. 2023

J Int Med Res

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Objective To test agreement and interchangeability between distal (dRA) and forearm radial arterial (RA) pressures (AP) during general anesthesia (GA) for prone spinal surgery. Methods This prospective observational study involved 40 patients scheduled for GA spinal surgery. The right dRA and left forearm RA were cannulated in all patients to continuously measure invasive blood pressures (IBP). We compared the agreement and trending ability of systolic AP (SAP), diastolic AP (DAP), and mean AP (MAP) at each site 15 minutes after tracheal intubation, start of surgery, 30 and 60 minutes after the start of surgery, and after skin suturing. Results Paired BP values (n = 184) (37 cases) were analyzed. The bias (standard deviation), limits of agreement, and percentage error were: SAP: 0.19 (3.03), −5.75 to 6.12, and 5.04%; DAP: −0.06 (1.75), −3.50 to 3.38, and 5.10%; and MAP: 0.08 (1.52), −2.90 to 3.05, and 3.54%, respectively. The linear regression coefficients of determination were 0.981, 0.982, and 0.988 for SAPs, DAPs, and MAPs, respectively; four-quadrant plot concordance rates were 95.11%, 92.03%, and 92.66%, respectively. Conclusion All arterial BPs showed good agreement and trending capabilities for both the dRA and RA. The dRA may be substituted for the RA in IBP monitoring.

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Section: Methodsmentioning

confidence: 99%

Section: Clinical and Perioperative Variablesmentioning

confidence: 99%

Agreement between distal and forearm radial arterial pressures in patients undergoing prone spinal surgery: a prospective, self-controlled, observational study

Xiong,

Xu,

Hui

et al. 2023

J Int Med Res

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“…The pressure transducer was connected to the invasive BP module of the ECG (Mindray Medical, Shenzhen, China), and the BP of patients were continuously measured after zero calibration. We excluded patients who underwent radial artery catheterization after the failure of dorsal foot artery catheterization due to the higher invasive dorsal foot artery SBP and lower MAP and DBP in the radial artery in patients under GA with sevo urane 41,42 . The anesthesiologist gave anesthesia-inducing drugs and endotracheal intubation according to a prescribed plan.…”

Section: Data Acquisitionmentioning

confidence: 99%

Development and validation of a post-induction hypotension prediction model of general anesthesia in adult patients.

Shui,

Liu,

Liao

2023

Preprint

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Backgroundː Post-induction hypotension (PIH) refers to arterial hypotension occurring within the first 20 minutes after anesthesia induction or from anesthesia induction to the beginning of surgery. Identifying high-risk patients with PIH is of great significance for medical staff to take corresponding preventive measures and formulating intervention plans. Therefore, this study aims to construct a PIH prediction model for patients undergoing general anesthesia (GA) and varify the performance of the model. It was hypothesized that we could create a prediction model with a sensitivity/specificity > 85%. Methodsː This is a cross-sectional, observational study performed in a tertiary hospital in southwest China, among 290 patients who underwent elective non-cardiac surgery under GA from March 2023 to May 2023. The data came from medical records and anesthesia information collection system. Variables included patient age, gender, heart rate (HR), body mass index (BMI), disease diagnosis, complications, drug use, Charlson comorbidity index (CCI), American society of anesthesiologists physical status classification (ASA), the last measured blood pressure (BP) in the ward, the BP before anesthesia induction, and the lowest BP during anesthesia induction. the lowest BP during anesthesia induction was measured by invasive measurement method. PIH was defined as a decrease of mean arterial blood pressure (MAP) during induction of more than 30% compared with the MAP measured before anesthesia induction. The data was divided into trainning set and validation set according to the ratio of 7:3. The least absolute shrinkage and selection operator (LASSO) binary logistic regression was used for feature selection and model training. The area under the receiver operating characteristic curve (AUROC) was used to test these hypotheses. A calibration curve and the Hosmer-Lemeshow (H-L) chi-square test were used to evaluate the calibration degree of the model. Decision curve analysis (DCA) was used to evaluate the performance of the modeling in supporting clinical decision-making. The model was then visualized using a nomogram. Results PIH was presented in 8% patients in the training set and 10% in the test set. The predictors of this model included BMI, changes in MAP, pre-operative HR, and pre-operative use of angiotensin-converting enzyme inhibitors (ACEIs)/angiotensin receptor blockers (ARBs). For the training and test sets, the AUROC using LASSO regression was 0.894 [95% CI, (0.78, 1.00)] and 0.883 [95% CI, (0.718, 1.00)], with respective sensitivity (0.880 and 0.901) and specificity ( 0.875 and 0.889). The H-L test of calibration curve was 3.42 and 11.265, with respective p value 0.905 and 0.187. The DCA demonstrated that using the model obtained higher net benefit (NB) than not using it. This model composed of these four independent variables showed good calibration, and clinical efficiency, which is helpful for medical staff to identify patients with high risk of PIH and formulate corresponding prevention and intervention strategies Conclusions BMI, MAP change, HR, and ACEIs/ARBs were predictive of PIH by LASSO regression. This model composed of these four independent variables showed good discrimination, calibration, and clinical efficiency, which is helpful for medical staff to identify patients with high risk of PIH and formulate corresponding prevention and intervention strategies. The prediction and validation model with a sensitivity/specificity > 85% means the model was “successful”.

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“…The posterior tibial and dorsal pedis arteries may be possible alternative access sites to the radial artery in pediatric patients without major complications [ 7 , 12 – 14 ]. A study comparing the anatomical characteristics and utility of ultrasound-guided catheterization using the long-axis in-plane (LAX-IP) approach among the radial, posterior tibial, and dorsal pedis arteries in small children found that the posterior tibial artery is a reasonable alternative access site for ultrasound-guided radial arterial catheterization [ 15 ] because the first-attempt success rate, catheterization time, and arterial diameter of the posterior tibial artery are similar to those of the radial artery.…”

Section: Where Is the Possible Access Site?mentioning

confidence: 99%

Ultrasound-guided peripheral vascular catheterization in pediatric patients: a narrative review

et al. 2020

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Peripheral vascular catheterization (PVC) in pediatric patients is technically challenging. Ultrasound guidance has gained the most interest in perioperative and intensive care fields because it visualizes the exact location of small target vessels and is less invasive than other techniques. There have been a growing number of studies related to ultrasound guidance for PVC with or without difficult access in pediatric patients, and most findings have demonstrated its superiority to other techniques. There are various ultrasound guidance approaches, and a comprehensive understanding of the basics, operator experience, and selection of appropriate techniques is required for the successful utilization of this technique. This narrative review summarizes the literature regarding ultrasound-guided PVC principles, approaches, and pitfalls to improve its clinical performance in pediatric settings.

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Gradient between dorsalis pedis and radial arterial blood pressures during sevoflurane anaesthesia

Abstract: www.chictr.org with registry number ChiCTR-RNRC-13003853.

Cited by 8 publications

References 25 publications

Agreement between distal and forearm radial arterial pressures in patients undergoing prone spinal surgery: a prospective, self-controlled, observational study

Agreement between distal and forearm radial arterial pressures in patients undergoing prone spinal surgery: a prospective, self-controlled, observational study

Development and validation of a post-induction hypotension prediction model of general anesthesia in adult patients.

Ultrasound-guided peripheral vascular catheterization in pediatric patients: a narrative review

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