Anesthesiology Research and Practice最新文献

{"title":"Combined Ventilation of Two Subjects with a Single Mechanical Ventilator Using a New Medical Device: An In Vitro Study.","authors":"Ignacio Lugones,&nbsp;Matías Ramos,&nbsp;María Fernanda Biancolini,&nbsp;Roberto Orofino Giambastiani","doi":"10.1155/2021/6691591","DOIUrl":"https://doi.org/10.1155/2021/6691591","url":null,"abstract":"<p><strong>Introduction: </strong>The SARS-CoV-2 pandemic has created a sudden lack of ventilators. DuplicAR^Ⓡ is a novel device that allows simultaneous and independent ventilation of two subjects with a single ventilator. The aims of this study are (a) to determine the efficacy of DuplicAR^Ⓡ to independently regulate the peak and positive-end expiratory pressures in each subject, both under pressure-controlled ventilation and volume-controlled ventilation and (b) to determine the ventilation mode in which DuplicAR^Ⓡ presents the best performance and safety.</p><p><strong>Materials and methods: </strong>Two test lungs are connected to a single ventilator using DuplicAR^Ⓡ. Three experimental stages are established: (1) two identical subjects, (2) two subjects with the same weight but different lung compliance, and (3) two subjects with different weights and lung compliances. In each stage, the test lungs are ventilated in two ventilation modes. The positive-end expiratory pressure requirements are increased successively in one of the subjects. The goal is to achieve a tidal volume of 7 ml/kg for each subject in all different stages through manipulation of the ventilator and the DuplicAR^Ⓡ controllers.</p><p><strong>Results: </strong>DuplicAR^Ⓡ allows adequate ventilation of two subjects with different weights and/or lung compliances and/or PEEP requirements. This is achieved by adjusting the total tidal volume for both subjects (in volume-controlled ventilation) or the highest peak pressure needed (in pressure-controlled ventilation) along with the basal positive-end expiratory pressure on the ventilator and simultaneously manipulating the DuplicAR^Ⓡ controllers to decrease the tidal volume or the peak pressure in the subject that needs less and/or to increase the positive-end expiratory pressure in the subject that needs more. While ventilatory goals can be achieved in any of the ventilation modes, DuplicAR^Ⓡ performs better in pressure-controlled ventilation, as changes experienced in the variables of one subject do not modify the other one.</p><p><strong>Conclusions: </strong>DuplicAR^Ⓡ is an effective tool to manage the peak inspiratory pressure and the positive-end expiratory pressure independently in two subjects connected to a single ventilator. The driving pressure can be adjusted to meet the requirements of subjects with different weights and lung compliances. Pressure-controlled ventilation has advantages over volume-controlled ventilation and is therefore the recommended ventilation mode.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-02-18","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896537/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25402407","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Perioperative Intravenous Patient-Controlled Analgesic Efficacy of Morphine with Combined Nefopam and Parecoxib versus Parecoxib in Gynecologic Surgery: A Randomized, Double-Blind Study.","authors":"Varinee Lekprasert,&nbsp;Lapuskorn Yapanan,&nbsp;Wichai Ittichaikulthol,&nbsp;Rungrawan Buachai,&nbsp;Phimol Soisod,&nbsp;Areepan Sophonsritsuk","doi":"10.1155/2021/5461890","DOIUrl":"https://doi.org/10.1155/2021/5461890","url":null,"abstract":"<p><strong>Background: </strong>Nefopam is a non-NSAIDs and opioid sparing centrally acting drug which is effective for a multimodal postoperative analgesia. The present study aimed to evaluate the analgesic efficacy of nefopam combined with parecoxib for gynecologic surgery.</p><p><strong>Methods: </strong>This randomized double-blinded control trial recruited participants (<i>n</i> = 72) who underwent gynecologic surgeries and divided them into either a nefopam or control group. The study group received parecoxib 40 mg plus nefopam 20 mg, while the control group received parecoxib 40 mg plus normal saline solution intravenously during open abdominal gynecological surgery. Both groups then received either nefopam or normal saline every 6 hours postoperatively for 24 hours. Intravenous patient-controlled analgesia with morphine was given for breakthrough pain within 24 h. The participants were evaluated for morphine consumption within 24 hours and postoperative pain using a verbal numerical rating scale (VNRS) at a postanesthetic care unit, at 6-, 12-, and 24-hour postoperative periods. Adverse effects were recorded.</p><p><strong>Results: </strong>Morphine consumption within 24 hours and adverse effects were not significantly different between both groups. Mean difference and 95% confident interval of morphine consumption between both groups was 1.00 (-4.56, 4.76), <i>P</i>=0.97. The VNRS on movement at 6 hours after surgery of the nefopam group was significantly different from that of the control group [mean (SD), 4.14 (2.11) vs. 5.14 (1.80), <i>P</i>=0.04]. The VNRS of the nefopam group at 12 hours after operation during resting and on movement was significantly different from that of the control group ([mean (SD), 1.47 (1.80) vs. 2.54 (2.15), <i>P</i>=0.03], [mean (SD), 3.22 (1.84) vs 4.17 (1.74), <i>P</i>=0.03]), respectively.</p><p><strong>Conclusions: </strong>The combined administration of nefopam and parecoxib during gynecologic surgery slightly reduced the VNRS at 6 and 12 hours postoperatively more than treatment with parecoxib.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-02-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7895606/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"25402406","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Smooth Extubation and Smooth Emergence Techniques: A Narrative Review.","authors":"Tiffany H Wong,&nbsp;Garret Weber,&nbsp;Apolonia E Abramowicz","doi":"10.1155/2021/8883257","DOIUrl":"https://doi.org/10.1155/2021/8883257","url":null,"abstract":"<p><p>There is a paucity of literature on extubation technique and a lack of consensus regarding the definition of smooth extubation. This narrative review paper defines an ideal extubation, otherwise known as a \"smooth extubation,\" reviews perioperative criteria for extubation and risks and adverse events related to extubation, and explores various perioperative techniques that can be used to achieve a smooth extubation while caring for an uncomplicated patient without significant risk factors for extubation failure. In light of the evolving practice during the SARS CoV2 (COVID-19) pandemic to minimize aerosol generation and infection transmission, smooth extubation is particularly important.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2021-01-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7822686/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38873036","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A New Medical Device to Provide Independent Ventilation to Two Subjects Using a Single Ventilator: Evaluation in Lung-Healthy Pigs.","authors":"Ignacio Lugones,&nbsp;Roberto Orofino Giambastiani,&nbsp;Oscar Robledo,&nbsp;Martín Marcos,&nbsp;Javier Mouly,&nbsp;Agustín Gallo,&nbsp;Verónica Laulhé,&nbsp;María Fernanda Biancolini","doi":"10.1155/2020/8866806","DOIUrl":"https://doi.org/10.1155/2020/8866806","url":null,"abstract":"<p><strong>Background: </strong>The global crisis situation caused by SARS-CoV-2 has created an explosive demand for ventilators, which cannot be met even in developed countries. Designing a simple and inexpensive device with the ability to increase the number of patients that can be connected to existing ventilators would have a major impact on the number of lives that could be saved. We conducted a study to determine whether two pigs with significant differences in size and weight could be ventilated simultaneously using a single ventilator connected to a new medical device called DuplicARⓇ.</p><p><strong>Methods: </strong>Six pigs (median weight 12 kg, range 9-25 kg) were connected in pairs to a single ventilator using the new device for 6 hours. Both the ventilator and the device were manipulated throughout the experiment according to the needs of each animal. Tidal volume and positive end-expiratory pressure were individually controlled with the device. Primary and secondary outcome variables were defined to assess ventilation and hemodynamics in all animals throughout the experiment.</p><p><strong>Results: </strong>Median difference in weight between the animals of each pair was 67% (range: 11-108). All animals could be successfully oxygenated and ventilated for 6 hours through manipulation of the ventilator and the DuplicARⓇ device, despite significant discrepancies in body size and weight. Mean PaCO₂ in arterial blood was 42.1 ± 4.4 mmHg, mean PaO₂ was 162.8 ± 46.8 mmHg, and mean oxygen saturation was 98 ± 1.3%. End-tidal CO₂ values showed no statistically significant difference among subjects of each pair. Mean difference in arterial PaCO₂ measured at the same time in both animals of each pair was 4.8 ± 3 mmHg, reflecting the ability of the device to ventilate each animal according to its particular requirements. Independent management of PEEP was achieved by manipulation of the device controllers.</p><p><strong>Conclusion: </strong>It is possible to ventilate two lung-healthy animals with a single ventilator according to each one's needs through manipulation of both the ventilator and the DuplicARⓇ device. This gives this device the potential to expand local ventilators surge capacity during disasters or pandemics until emergency supplies can be delivered from central stockpiles.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-12-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7774300/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38831361","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The Role of Interfascial Plane Blocks in Paediatric Regional Anaesthesia: A Narrative Review of Current Perspectives and Updates.","authors":"Sujana Dontukurthy,&nbsp;Roshanak Mofidi","doi":"10.1155/2020/8892537","DOIUrl":"https://doi.org/10.1155/2020/8892537","url":null,"abstract":"<p><p>Regional anaesthesia has been increasingly used for analgesia in the perioperative period in paediatric anaesthesia for better pain control and improved patient outcomes. Interfascial plane blocks are considered as a subgroup of peripheral nerve blocks. The advent of ultrasound in modern regional anaesthesia practice has led to the evolution of various interfascial plane blocks. The ease of their performance and the low complication rates, compared with neuraxial anaesthesia, have led to their increased use in the perioperative period. Interfascial plane blocks are often incorporated in the multimodal analgesia regimen in the early recovery and ambulation after surgery protocols for various chest wall and abdominal surgeries. This achieves better pain control and decreases the requirements of opioids in the perioperative period, thereby facilitating early mobilization and discharge. This narrative review focuses on the relevant anatomic considerations, technique for the performance of each block along with its current applications and limitations, and includes a review of the current literature on various interfascial plane blocks in paediatric regional anaesthesia.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7765726/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38767655","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Antibiotic Prophylaxis for Cesarean Delivery: A Survey of Anesthesiologists.","authors":"Emily S Reiff,&nbsp;Ashraf S Habib,&nbsp;Brendan Carvalho,&nbsp;Karthik Raghunathan","doi":"10.1155/2020/3741608","DOIUrl":"https://doi.org/10.1155/2020/3741608","url":null,"abstract":"<p><strong>Background: </strong>The most common complication after cesarean delivery is surgical site infection. Antibiotic prophylaxis reduces infectious morbidity and current anesthetic quality metrics include preincision antibiotic prophylaxis. Recently, studies suggest reductions in infectious morbidity with the addition of azithromycin for unscheduled cesarean delivery. Larger doses of cefazolin are recommended for morbidly obese women, but evidence is conflicting. The aim of this study was to survey anesthesiologists to assess current practice for antibiotic prophylaxis for cesarean delivery.</p><p><strong>Methods: </strong>We invited a random sample of 10,000 current members of the American Society of Anesthesiologists to complete an online survey about their current practice of antibiotic prophylaxis for cesarean delivery in November 2017. The survey included questions similar to a previous survey on this topic in 2012.</p><p><strong>Results: </strong>The response rate was 12.2% (<i>n</i> = 1223). Most respondents had at least 15 years of experience (684, 55.9%), work at a nonteaching or community hospital (729, 59.6%), with >500 cesarean deliveries annually (619, 50.6%), and administer obstetric anesthesia several times a week (690, 56.4%). Routine preincision antibiotic prophylaxis was reported by 1162 (95.0%) of the 1223 respondents, a substantial improvement versus the 63.5% reported in the previous study in 2012. For intrapartum cesarean deliveries, 141 (11.5%) administer azithromycin for unscheduled cesarean deliveries. Those who use cefazolin, 509 (42.5%) administer 3 g for morbidly obese women.</p><p><strong>Conclusion: </strong>Adherence to preincision antibiotic prophylaxis for cesarean delivery is very high, a significant improvement within 5 years. A minority of anesthesiologists utilize azithromycin for intrapartum cesarean deliveries. The dose of cefazolin for morbidly obese women varies widely.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7787788/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38854068","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Emergency Tracheal Intubation in Patients with COVID-19: Experience from a UK Centre.","authors":"Ajay Gandhi, Jagdish Sokhi, Chris Lockie, Patrick A Ward","doi":"10.1155/2020/8816729","DOIUrl":"10.1155/2020/8816729","url":null,"abstract":"<p><p>This retrospective observational case series describes a single centre's preparations and experience of 53 emergency tracheal intubations in patients with COVID-19 respiratory failure. The findings of a contemporaneous online survey exploring technical and nontechnical aspects of airway management, completed by intubation team members, are also presented. Preparations included developing a COVID-19 intubation standard operating procedure and checklist, dedicated airway trolleys, a consultant-led mobile intubation team, and an airway education programme. Tracheal intubation was successful in all patients. Intubation first-pass success rate was 85%, first-line videolaryngoscopy use 79%, oxygen desaturation 49%, and hypotension 21%. Performance was consistent across all clinical areas. The main factor impeding first-pass success was larger diameter tracheal tubes. The majority of intubations was performed by consultant anaesthetists. Nonconsultant intubations demonstrated higher oxygen desaturation rates (75% vs. 45%, <i>p</i>=0.610) and lower first-pass success (0% vs. 92%, <i>p</i> < 0.001). Survey respondents (<i>n</i> = 29) reported increased anxiety at the start of the pandemic, with statistically significant reduction as the pandemic progressed (median: 4/5 very high vs. 2/5 low anxiety, <i>p</i> < 0.001). Reported procedural/environmental challenges included performing tasks in personal protective equipment (62%), remote-site working (48%), and modification of normal practices (41%)-specifically, the use of larger diameter tracheal tubes (21%). Hypoxaemia was identified by 90% of respondents as the most challenging patient-related factor during intubations. Our findings demonstrate that a consultant-led mobile intubation team can safely perform tracheal intubation in critically ill COVID-19 patients across all clinical areas, aided by thorough preparation and training, despite heightened anxiety levels.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-12-10","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7729388/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38762381","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Criteria of Postoperative Cognitive Dysfunction: A Focused Systematic Review.","authors":"Kim van Sinderen,&nbsp;Lothar A Schwarte,&nbsp;Patrick Schober","doi":"10.1155/2020/7384394","DOIUrl":"https://doi.org/10.1155/2020/7384394","url":null,"abstract":"<p><p>Postoperative Cognitive Dysfunction (POCD) is characterized by a deterioration in cognitive performance after surgery and is increasingly addressed in research studies. However, a uniform definition of POCD seems to be lacking, which is a major threat to clinical research in this area. We performed a focused systematic review to determine the current degree of heterogeneity in how POCD is defined across studies and to identify those diagnostic criteria that are used most commonly. The search identified 173 records, of which 30 were included. Neurocognitive testing was most commonly performed shortly before surgery and at 7 days postoperatively. A variety of neurocognitive tests were used to test a range of cognitive domains, including complex attention, language, executive functioning, perceptual-motor function, and learning and memory. The tests that were used most commonly were the Mini-Mental State Examination, the digit span test, the trail making test part A, and the digit symbol substitution test, but consensus on which test result would be considered \"positive\" for POCD was sparse. The results of this systematic review suggest the lack of a consistent approach towards defining POCD. However, commonalities were identified which may serve as a common denominator for deriving consensus-based diagnostic guidelines for POCD.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-11-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/7384394","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38680667","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Minimally Invasive Hemodynamic Assessment during Obstetric Hysterectomy for Invasive Placentation with Epidural Anesthesia.","authors":"S Alvarado-Ramos,&nbsp;V J Lara-Díaz,&nbsp;M R López-Gutiérrez,&nbsp;M E Torcida-González,&nbsp;J F Campos-Rodríguez","doi":"10.1155/2020/1968354","DOIUrl":"https://doi.org/10.1155/2020/1968354","url":null,"abstract":"<p><strong>Background: </strong>The present study aimed to describe the evolution of hemodynamic parameters over time of patients with invasive placentation during their third trimester who were delivered via cesarean section and subsequently underwent obstetric hysterectomy under epidural anesthesia.</p><p><strong>Methods: </strong>A prospective, descriptive, longitudinal, 11-month cohort study of 43 patients aged between 18 and 37 years who presented with invasive placentation. Minimal invasive monitoring was placed before the administration of epidural anesthesia for hemodynamic parameter tracking during the cesarean section. After delivery, the patients underwent an obstetric hysterectomy. Blood loss, hemodynamic parameters, and coagulation were managed via goal-directed therapy. Parameters were compared via repeated measures ANOVA and effect size estimation (Cohen's d).</p><p><strong>Results: </strong>The mean age of the patients was 29.2 ± 3.4 years and was moderately overweight. They had minor cardiac index variance (<i>P</i>=NS, no significance), vascular systemic resistance index (NS), heart rate (<i>P</i>=NS), and median arterial pressure (<i>P</i>=NS). Differences were observed in the stroke volume index (<i>P</i>=0.015) due to moderately higher values (<i>d</i> = 0.3, <i>P</i>=0.016) in the middle of the surgery. Patients had lower cardiac index (<i>d</i> = -0.36, NS) and cardiac workload requirements (<i>d</i> = -0.29, <i>P</i>=0.034) toward the completion of surgery.</p><p><strong>Conclusion: </strong>Patients who are in their third trimester and who subsequently underwent obstetric hysterectomy under epidural anesthesia had modest surgical hemodynamic variance and reduced cardiac workload requirements toward the end of the surgery.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-10-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1968354","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38711225","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Feasibility of Anesthesiologist-Performed Preoperative Echocardiography for the Prediction of Postinduction Hypotension: A Prospective Observational Study.","authors":"Babar Fiza,&nbsp;Neal Duggal,&nbsp;Caitlin E McMillan,&nbsp;Graciela Mentz,&nbsp;Michael D Maile","doi":"10.1155/2020/1375741","DOIUrl":"https://doi.org/10.1155/2020/1375741","url":null,"abstract":"<p><strong>Purpose: </strong>To determine if left ventricular or inferior vena cava (IVC) measurements are easier to obtain on point-of-care ultrasound by anesthesiologists in preoperative patients, and to assess the relationship between preoperative cardiac dimensions and hypotension with the induction of general anesthesia.</p><p><strong>Methods: </strong>This prospective observational study was conducted at a large academic medical center. Sixty-three patients undergoing noncardiac surgeries under general anesthesia were enrolled. Ultrasound examinations were performed by anesthesiologists in the preoperative area. To ensure that hypotension represented both a relative and absolute decrease in blood pressure, both a mean arterial pressure (MAP) < 65 mmHg and a MAP decrease of >30% from preoperative value defined this outcome.</p><p><strong>Results: </strong>Left ventricular measurements were more likely to be acquired than IVC measurements (97% vs. 79%). Subjects without adequate images to assess IVC collapsibility tended to have a higher body mass index (33.6 ± 5.5 vs. 28.5 ± 4.5, <i>p</i>=0.001). While high left ventricular end-diastolic diameter values were associated with a decreased odds of MAP < 65 mmHg (OR: 0.24, 95% CI: 0.07-0.83, <i>p</i>=0.023) or a MAP decrease of >30% from baseline alone (OR: 0.25, 95% CI: 0.07-0.83, <i>p</i>=0.023), the primary endpoint of both relative and absolute hypotension was not associated with preoperative left ventricular dimensions.</p><p><strong>Conclusions: </strong>Preoperative cardiac ultrasound may be a more reliable way for anesthesiologists to assess patients' volume status compared to ultrasound of the IVC, particularly for patients with a higher body mass index.</p>","PeriodicalId":7834,"journal":{"name":"Anesthesiology Research and Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2020-10-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1155/2020/1375741","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"38553836","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}