Prediction of hypotension after postural change in robot-assisted laparoscopic prostatectomy using esophageal Doppler monitoring: a prospective observational trial

Abstract Postural change from a steep Trendelenburg position to a supine position (T-off) during robot-assisted laparoscopic prostatectomy (RALP) induces a considerable abrupt decrease in the mean arterial pressure (MAP). We investigated the variables for predicting postural hypotension induced by T...

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Autores principales:	Na Young Kim, Ki Jun Kim, Tae Lim Kim, Hye Jung Shin, Chaerim Oh, Min Huiy Lee, Ji Young Min, So Yeon Kim
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2021
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/37f61288633846a2b454d168e061d1df
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spelling	oai:doaj.org-article:37f61288633846a2b454d168e061d1df2021-12-02T15:33:12ZPrediction of hypotension after postural change in robot-assisted laparoscopic prostatectomy using esophageal Doppler monitoring: a prospective observational trial10.1038/s41598-021-93990-32045-2322https://doaj.org/article/37f61288633846a2b454d168e061d1df2021-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-021-93990-3https://doaj.org/toc/2045-2322Abstract Postural change from a steep Trendelenburg position to a supine position (T-off) during robot-assisted laparoscopic prostatectomy (RALP) induces a considerable abrupt decrease in the mean arterial pressure (MAP). We investigated the variables for predicting postural hypotension induced by T-off using esophageal Doppler monitoring (EDM). One hundred and twenty-five patients undergoing RALP were enrolled. Data on the MAP, heart rate, stroke volume index (SVI), cardiac index, peak velocity, corrected flow time, stroke volume variation, pulse pressure variation, arterial elastance (Ea), and dynamic arterial elastance were collected before T-off and at 1, 3, 5, 7, and 10 min after T-off using EDM. MAP < 60 mmHg within 10 min after T-off was considered to indicate hypotension, and 25 patients developed hypotension. The areas under the curves of the MAP, SVI, and Ea were 0.734 (95% confidence interval [CI] 0.623–0.846; P < 0.001), 0.712 (95% CI 0.598–0.825; P < 0.001), and 0.760 (95% CI 0.646–0.875; P < 0.001), respectively, with threshold values of ≤ 74 mmHg, ≥ 42.5 mL/m2, and ≤ 1.08 mmHg/mL, respectively. If patients have MAP < 75 mmHg with SVI ≥ 42.5 mL/m2 or Ea ≤ 1.08 mmHg/mL before postural change from T-off during RALP, prompt management for ensuing hypotension should be considered. Trial registration: NCT03882697 (ClinicalTrial.gov, March 20, 2019).Na Young KimKi Jun KimTae Lim KimHye Jung ShinChaerim OhMin Huiy LeeJi Young MinSo Yeon KimNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 11, Iss 1, Pp 1-7 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Na Young Kim Ki Jun Kim Tae Lim Kim Hye Jung Shin Chaerim Oh Min Huiy Lee Ji Young Min So Yeon Kim Prediction of hypotension after postural change in robot-assisted laparoscopic prostatectomy using esophageal Doppler monitoring: a prospective observational trial
description	Abstract Postural change from a steep Trendelenburg position to a supine position (T-off) during robot-assisted laparoscopic prostatectomy (RALP) induces a considerable abrupt decrease in the mean arterial pressure (MAP). We investigated the variables for predicting postural hypotension induced by T-off using esophageal Doppler monitoring (EDM). One hundred and twenty-five patients undergoing RALP were enrolled. Data on the MAP, heart rate, stroke volume index (SVI), cardiac index, peak velocity, corrected flow time, stroke volume variation, pulse pressure variation, arterial elastance (Ea), and dynamic arterial elastance were collected before T-off and at 1, 3, 5, 7, and 10 min after T-off using EDM. MAP < 60 mmHg within 10 min after T-off was considered to indicate hypotension, and 25 patients developed hypotension. The areas under the curves of the MAP, SVI, and Ea were 0.734 (95% confidence interval [CI] 0.623–0.846; P < 0.001), 0.712 (95% CI 0.598–0.825; P < 0.001), and 0.760 (95% CI 0.646–0.875; P < 0.001), respectively, with threshold values of ≤ 74 mmHg, ≥ 42.5 mL/m2, and ≤ 1.08 mmHg/mL, respectively. If patients have MAP < 75 mmHg with SVI ≥ 42.5 mL/m2 or Ea ≤ 1.08 mmHg/mL before postural change from T-off during RALP, prompt management for ensuing hypotension should be considered. Trial registration: NCT03882697 (ClinicalTrial.gov, March 20, 2019).
format	article
author	Na Young Kim Ki Jun Kim Tae Lim Kim Hye Jung Shin Chaerim Oh Min Huiy Lee Ji Young Min So Yeon Kim
author_facet	Na Young Kim Ki Jun Kim Tae Lim Kim Hye Jung Shin Chaerim Oh Min Huiy Lee Ji Young Min So Yeon Kim
author_sort	Na Young Kim
title	Prediction of hypotension after postural change in robot-assisted laparoscopic prostatectomy using esophageal Doppler monitoring: a prospective observational trial
title_short	Prediction of hypotension after postural change in robot-assisted laparoscopic prostatectomy using esophageal Doppler monitoring: a prospective observational trial
title_full	Prediction of hypotension after postural change in robot-assisted laparoscopic prostatectomy using esophageal Doppler monitoring: a prospective observational trial
title_fullStr	Prediction of hypotension after postural change in robot-assisted laparoscopic prostatectomy using esophageal Doppler monitoring: a prospective observational trial
title_full_unstemmed	Prediction of hypotension after postural change in robot-assisted laparoscopic prostatectomy using esophageal Doppler monitoring: a prospective observational trial
title_sort	prediction of hypotension after postural change in robot-assisted laparoscopic prostatectomy using esophageal doppler monitoring: a prospective observational trial
publisher	Nature Portfolio
publishDate	2021
url	https://doaj.org/article/37f61288633846a2b454d168e061d1df
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Prediction of hypotension after postural change in robot-assisted laparoscopic prostatectomy using esophageal Doppler monitoring: a prospective observational trial

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