Hemodynamic Effect of the Prone Position During Anesthesia

Yokoyama, Masataka; Ueda, Wasa; Hirakawa, Masahisa; Yamamoto, Hiroshi

doi:10.1097/00132586-199208000-00024

Cited by 29 publications

(48 citation statements)

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“…This suggests that baroreflex-mediated HR responses may be impaired during this period, resulting in a reduced ability to maintain MAP in the prone position, potentially reflecting reduced cardiac output. This is consistent with findings of reduced cardiac index, a measure of cardiac output relative to body surface area, in adults 47,48 and children 49 in the prone compared with the supine position. Reduced cardiac output may explain the large deficit in cerebral oxygenation seen in the prone position at 2 to 3 months CA.…”

Section: Figuresupporting

confidence: 89%

Cerebral Oxygenation in Preterm Infants

et al. 2014

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BACKGROUND AND OBJECTIVE: Prone sleeping is a major risk factor for sudden infant death syndrome (SIDS) and preterm infants are at significantly increased risk. In term infants, prone sleeping is associated with reduced mean arterial pressure (MAP) and cerebral tissue oxygenation index (TOI). However, little is known about the effects of sleeping position on TOI and MAP in preterm infants. We aimed to examine TOI and MAP in preterm infants after term-equivalent age, during the period of greatest SIDS risk. METHODS: Thirty-five preterm and 17 term infants underwent daytime polysomnography, including measurement of TOI (NIRO-200 spectrophotometer, Hamamatsu Photonics KK, Japan) and MAP (Finapress Medical Systems, Amsterdam, Netherlands) at 2 to 4 weeks, 2 to 3 months, and 5 to 6 months postterm age. Infants slept prone and supine in active and quiet sleep. The effects of sleep state and position were determined by using 2-way repeated measures analysis of variance and of preterm birth by using 2-way analysis of variance. RESULTS: In preterm infants, TOI was significantly lower when prone compared with supine in both sleep states at all ages (P < .05). Notably, TOI was significantly lower in preterm compared with term infants at 2 to 4 weeks, in both positions (P < .05), and at 2 to 3 months when prone (P < .001), in both sleep states. MAP was also lower in preterm infants in the prone position at 2 to 3 months (P < .01). CONCLUSIONS: Cerebral oxygenation is reduced in the prone position in preterm infants and is lower compared with age-matched term infants, predominantly in the prone position when MAP is also reduced. This may contribute to their increased SIDS risk.

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Section: Figuresupporting

confidence: 89%

Cerebral Oxygenation in Preterm Infants

et al. 2014

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“…Yokoyama and colleagues [2] and Backofen and Schauble [ 11 showed that cardiac index measured by thermodilution pulmonary artery catheters is reduced by between 17 and 24% in anaesthetised patients who are transferred from the supine to the prone position. However, they only looked at one position.…”

Section: Discussionmentioning

confidence: 99%

“…There is a compensatory change in total vascular resistance index in order to maintain mean arterial pressure. Yokoyama and colleagues [2] concluded that the prone position itself may not interfere with circulatory function, but using a convex saddle frame causes a significant reduction in cardiac index. Our study appears to confirm this conclusion.…”

Section: Discussionmentioning

confidence: 99%

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The effect of four different surgical prone positions on cardiovascular parameters in healthy volunteers

1996

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“…Regarding the frames, some suggested that the SV decreases when patients are placed on a convex saddle frame [6,8,12]. In the current study, a longitudinal bolster device that partially supports the chest and pelvis, partially compresses the abdomen, and positions the legs above the heart was used.…”

Section: Discussionmentioning

confidence: 96%