Abstract

The prone position can reduce cardiac output by up to 25% due to reduced preload. We hypothesised that preload optimisation targeted to stroke volume variation before turning prone might alleviate this. A supine threshold stroke volume variation of 14% in a preliminary study identified patients whose cardiac outputs would decline when turned prone. In 45 patients, cardiac output declined only in the group whose supine stroke volume variation was high (mean (SD) 5.1 (2.0) to 3.9 (1.9) l.min(-1) ; p < 0.001), but not in patients in whom it was low, or in those in whom stroke volume variation was high, but who received volume preload (p = 0.525 and 0.941, respectively). We conclude that targeted preload optimisation using a supine stroke volume variation value < 14% is effective in preventing falls in cardiac output induced by the prone position.

Links

Publisher Full Text

Authors

Wu CY, Lee TS, Chan KC, Jeng CS, Cheng YJ

Institution

Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.

Source

Anaesthesia 67:7 2012 Jul pg 760-4

MeSH

Adult
Aged
Cardiac Output
Female
Hemodynamics
Humans
Intraoperative Care
Lumbar Vertebrae
Male
Middle Aged
Patient Positioning
Pilot Projects
Preoperative Period
Prone Position
Sensitivity and Specificity
Stroke Volume
Supine Position
Young Adult

Pub Type(s)

Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

22452326