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Pulse Pressure Analysis to Guide Intraoperative Phlebotomy Prior to Cardiac Surgery
BACKGROUND: The aim of this study was to evaluate the response of the LiDCO-rapid™ during intraoperative phlebotomy in anesthetized children prior to surgery for congenital heart disease. METHODS: After the induction of general anesthesia and endotracheal intubation, baseline vital signs were record...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Elmer Press
2017
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755658/ https://www.ncbi.nlm.nih.gov/pubmed/29317969 http://dx.doi.org/10.14740/cr634w |
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author | Schloss, Brian Tumin, Dmitry Naguib, Aymen Rice, Julie Galantowicz, Mark Tobias, Joseph D. |
author_facet | Schloss, Brian Tumin, Dmitry Naguib, Aymen Rice, Julie Galantowicz, Mark Tobias, Joseph D. |
author_sort | Schloss, Brian |
collection | PubMed |
description | BACKGROUND: The aim of this study was to evaluate the response of the LiDCO-rapid™ during intraoperative phlebotomy in anesthetized children prior to surgery for congenital heart disease. METHODS: After the induction of general anesthesia and endotracheal intubation, baseline vital signs were recorded, along with pulse pressure variability (PPV) and stroke volume variability (SVV) from the LiDCO-rapid™ and cerebral oxygenation (rSO(2)) using near-infrared spectroscopy (NIRS). Phlebotomy was performed over 5 - 10 min with the volume of blood removed calculated to achieve a hematocrit of 24-28% on cardiopulmonary bypass. The primary outcome was a decline in rSO(2) ≥ 5 between the baseline value and the end of phlebotomy. At that time, the correlation of the starting and ending values of SVV and PPV with the NIRS was determined. RESULTS: The study cohort included 30 patients (mean age of 21 ± 11 years). Statistically significant changes during the study period were observed in rSO(2), but not in the LiDCO-rapid™ parameters. In analysis of continuous NIRS data, the change in NIRS did not correlate with either baseline (r = 0.10, P = 0.644) or final (r = 0.02, P = 0.914) SVV. Likewise, the change in NIRS did not correlate with baseline (r = 0.01, P = 0.953) or final (r = 0.00, P = 0.982) PPV. CONCLUSION: Baseline values as well as changes in the PVV and SVV from the LiDCO-rapid™ did not predict or correlate with changes in cerebral oxygenation measured by NIRS during intraoperative phlebotomy. Our preliminary data suggest that these parameters (PVV and SVV) are not useful in monitoring patient stability or the need for volume replacement during intraoperative phlebotomy prior to cardiac surgery. |
format | Online Article Text |
id | pubmed-5755658 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2017 |
publisher | Elmer Press |
record_format | MEDLINE/PubMed |
spelling | pubmed-57556582018-01-09 Pulse Pressure Analysis to Guide Intraoperative Phlebotomy Prior to Cardiac Surgery Schloss, Brian Tumin, Dmitry Naguib, Aymen Rice, Julie Galantowicz, Mark Tobias, Joseph D. Cardiol Res Original Article BACKGROUND: The aim of this study was to evaluate the response of the LiDCO-rapid™ during intraoperative phlebotomy in anesthetized children prior to surgery for congenital heart disease. METHODS: After the induction of general anesthesia and endotracheal intubation, baseline vital signs were recorded, along with pulse pressure variability (PPV) and stroke volume variability (SVV) from the LiDCO-rapid™ and cerebral oxygenation (rSO(2)) using near-infrared spectroscopy (NIRS). Phlebotomy was performed over 5 - 10 min with the volume of blood removed calculated to achieve a hematocrit of 24-28% on cardiopulmonary bypass. The primary outcome was a decline in rSO(2) ≥ 5 between the baseline value and the end of phlebotomy. At that time, the correlation of the starting and ending values of SVV and PPV with the NIRS was determined. RESULTS: The study cohort included 30 patients (mean age of 21 ± 11 years). Statistically significant changes during the study period were observed in rSO(2), but not in the LiDCO-rapid™ parameters. In analysis of continuous NIRS data, the change in NIRS did not correlate with either baseline (r = 0.10, P = 0.644) or final (r = 0.02, P = 0.914) SVV. Likewise, the change in NIRS did not correlate with baseline (r = 0.01, P = 0.953) or final (r = 0.00, P = 0.982) PPV. CONCLUSION: Baseline values as well as changes in the PVV and SVV from the LiDCO-rapid™ did not predict or correlate with changes in cerebral oxygenation measured by NIRS during intraoperative phlebotomy. Our preliminary data suggest that these parameters (PVV and SVV) are not useful in monitoring patient stability or the need for volume replacement during intraoperative phlebotomy prior to cardiac surgery. Elmer Press 2017-12 2017-12-22 /pmc/articles/PMC5755658/ /pubmed/29317969 http://dx.doi.org/10.14740/cr634w Text en Copyright 2017, Schloss et al. http://creativecommons.org/licenses/by-nc/4.0/ This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Schloss, Brian Tumin, Dmitry Naguib, Aymen Rice, Julie Galantowicz, Mark Tobias, Joseph D. Pulse Pressure Analysis to Guide Intraoperative Phlebotomy Prior to Cardiac Surgery |
title | Pulse Pressure Analysis to Guide Intraoperative Phlebotomy Prior to Cardiac Surgery |
title_full | Pulse Pressure Analysis to Guide Intraoperative Phlebotomy Prior to Cardiac Surgery |
title_fullStr | Pulse Pressure Analysis to Guide Intraoperative Phlebotomy Prior to Cardiac Surgery |
title_full_unstemmed | Pulse Pressure Analysis to Guide Intraoperative Phlebotomy Prior to Cardiac Surgery |
title_short | Pulse Pressure Analysis to Guide Intraoperative Phlebotomy Prior to Cardiac Surgery |
title_sort | pulse pressure analysis to guide intraoperative phlebotomy prior to cardiac surgery |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5755658/ https://www.ncbi.nlm.nih.gov/pubmed/29317969 http://dx.doi.org/10.14740/cr634w |
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