Safe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics

Abstract Aim of this study was to determine if perioperative hemodynamics have an impact on perioperative infarct volume and patients’ prognosis. 201 cases with surgery for a newly diagnosed or recurrent glioblastoma were retrospectively analyzed. Clinical data and perioperative hemodynamic paramete...

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Autores principales:	Stefanie Bette, Benedikt Wiestler, Felicitas Wiedenmann, Johannes Kaesmacher, Martin Bretschneider, Melanie Barz, Thomas Huber, Yu-Mi Ryang, Eberhard Kochs, Claus Zimmer, Bernhard Meyer, Tobias Boeckh-Behrens, Jan S. Kirschke, Jens Gempt
Formato:	article
Lenguaje:	EN
Publicado:	Nature Portfolio 2017
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/9bef38b9ba1b46288feda9231d627da7
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spelling	oai:doaj.org-article:9bef38b9ba1b46288feda9231d627da72021-12-02T12:30:43ZSafe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics10.1038/s41598-017-05767-22045-2322https://doaj.org/article/9bef38b9ba1b46288feda9231d627da72017-07-01T00:00:00Zhttps://doi.org/10.1038/s41598-017-05767-2https://doaj.org/toc/2045-2322Abstract Aim of this study was to determine if perioperative hemodynamics have an impact on perioperative infarct volume and patients’ prognosis. 201 cases with surgery for a newly diagnosed or recurrent glioblastoma were retrospectively analyzed. Clinical data and perioperative hemodynamic parameters, blood tests and time of surgery were recorded. Postoperative infarct volume was quantitatively assessed by semiautomatic segmentation. Mean diastolic blood pressure (dBP) during surgery (rho −0.239, 95% CI −0.11 – −0.367, p = 0.017), liquid balance (rho 0.236, 95% CI 0.1–0.373, p = 0.017) and mean arterial pressure (MAP) during surgery (rho −0.206, 95% CI −0.07 – −0.34, p = 0.041) showed significant correlation to infarct volume. A rank regression model including also age and recurrent surgery as possible confounders revealed mean intraoperative dBP, liquid balance and length of surgery as independent factors for infarct volume. Univariate survival analysis showed mean intraoperative dBP and MAP as significant prognostic factors, length of surgery also remained as significant prognostic factor in a multivariate model. Perioperative close anesthesiologic monitoring of blood pressure and liquid balance is of high significance during brain tumor surgery and should be performed to prevent or minimize perioperative infarctions and to prolong survival.Stefanie BetteBenedikt WiestlerFelicitas WiedenmannJohannes KaesmacherMartin BretschneiderMelanie BarzThomas HuberYu-Mi RyangEberhard KochsClaus ZimmerBernhard MeyerTobias Boeckh-BehrensJan S. KirschkeJens GemptNature PortfolioarticleMedicineRScienceQENScientific Reports, Vol 7, Iss 1, Pp 1-8 (2017)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Stefanie Bette Benedikt Wiestler Felicitas Wiedenmann Johannes Kaesmacher Martin Bretschneider Melanie Barz Thomas Huber Yu-Mi Ryang Eberhard Kochs Claus Zimmer Bernhard Meyer Tobias Boeckh-Behrens Jan S. Kirschke Jens Gempt Safe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics
description	Abstract Aim of this study was to determine if perioperative hemodynamics have an impact on perioperative infarct volume and patients’ prognosis. 201 cases with surgery for a newly diagnosed or recurrent glioblastoma were retrospectively analyzed. Clinical data and perioperative hemodynamic parameters, blood tests and time of surgery were recorded. Postoperative infarct volume was quantitatively assessed by semiautomatic segmentation. Mean diastolic blood pressure (dBP) during surgery (rho −0.239, 95% CI −0.11 – −0.367, p = 0.017), liquid balance (rho 0.236, 95% CI 0.1–0.373, p = 0.017) and mean arterial pressure (MAP) during surgery (rho −0.206, 95% CI −0.07 – −0.34, p = 0.041) showed significant correlation to infarct volume. A rank regression model including also age and recurrent surgery as possible confounders revealed mean intraoperative dBP, liquid balance and length of surgery as independent factors for infarct volume. Univariate survival analysis showed mean intraoperative dBP and MAP as significant prognostic factors, length of surgery also remained as significant prognostic factor in a multivariate model. Perioperative close anesthesiologic monitoring of blood pressure and liquid balance is of high significance during brain tumor surgery and should be performed to prevent or minimize perioperative infarctions and to prolong survival.
format	article
author	Stefanie Bette Benedikt Wiestler Felicitas Wiedenmann Johannes Kaesmacher Martin Bretschneider Melanie Barz Thomas Huber Yu-Mi Ryang Eberhard Kochs Claus Zimmer Bernhard Meyer Tobias Boeckh-Behrens Jan S. Kirschke Jens Gempt
author_facet	Stefanie Bette Benedikt Wiestler Felicitas Wiedenmann Johannes Kaesmacher Martin Bretschneider Melanie Barz Thomas Huber Yu-Mi Ryang Eberhard Kochs Claus Zimmer Bernhard Meyer Tobias Boeckh-Behrens Jan S. Kirschke Jens Gempt
author_sort	Stefanie Bette
title	Safe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics
title_short	Safe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics
title_full	Safe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics
title_fullStr	Safe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics
title_full_unstemmed	Safe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics
title_sort	safe brain tumor resection does not depend on surgery alone - role of hemodynamics
publisher	Nature Portfolio
publishDate	2017
url	https://doaj.org/article/9bef38b9ba1b46288feda9231d627da7
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Safe Brain Tumor Resection Does not Depend on Surgery Alone - Role of Hemodynamics

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