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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...

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Autores principales: Schloss, Brian, Tumin, Dmitry, Naguib, Aymen, Rice, Julie, Galantowicz, Mark, Tobias, Joseph D.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Elmer Press 2017
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.
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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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