Changes in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position

Abstract Background The present study aimed to evaluate the reliability of hemodynamic changes induced by lung recruitment maneuver (LRM) in predicting stroke volume (SV) increase after fluid loading (FL) in prone position. Methods Thirty patients undergoing spine surgery in prone position were enro...

Descripción completa

Guardado en:

Detalles Bibliográficos
Autores principales:	Ryota Watanabe, Koichi Suehiro, Akira Mukai, Katsuaki Tanaka, Tokuhiro Yamada, Takashi Mori, Kiyonobu Nishikawa
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Lung recruitment maneuver Prone position Fluid responsiveness Stroke volume Anesthesiology RD78.3-87.3
Acceso en línea:	https://doaj.org/article/b1c086d7970d45a397a48b5928df5018
Etiquetas:	Agregar Etiqueta Sin Etiquetas, Sea el primero en etiquetar este registro!

id	oai:doaj.org-article:b1c086d7970d45a397a48b5928df5018
record_format	dspace
spelling	oai:doaj.org-article:b1c086d7970d45a397a48b5928df50182021-12-05T12:08:00ZChanges in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position10.1186/s12871-021-01527-y1471-2253https://doaj.org/article/b1c086d7970d45a397a48b5928df50182021-12-01T00:00:00Zhttps://doi.org/10.1186/s12871-021-01527-yhttps://doaj.org/toc/1471-2253Abstract Background The present study aimed to evaluate the reliability of hemodynamic changes induced by lung recruitment maneuver (LRM) in predicting stroke volume (SV) increase after fluid loading (FL) in prone position. Methods Thirty patients undergoing spine surgery in prone position were enrolled. Lung-protective ventilation (tidal volume, 6–7 mL/kg; positive end-expiratory pressure, 5 cmH2O) was provided to all patients. LRM (30 cmH2O for 30 s) was performed. Hemodynamic variables including mean arterial pressure (MAP), heart rate, SV, SV variation (SVV), and pulse pressure variation (PPV) were simultaneously recorded before, during, and at 5 min after LRM and after FL (250 mL in 10 min). Receiver operating characteristic curves were generated to evaluate the predictability of SVV, PPV, and SV decrease by LRM (ΔSVLRM) for SV responders (SV increase after FL > 10%). The gray zone approach was applied for ΔSVLRM. Results Areas under the curve (AUCs) for ΔSVLRM, SVV, and PPV to predict SV responders were 0.778 (95% confidence interval: 0.590–0.909), 0.563 (0.371–0.743), and 0.502 (0.315–0.689), respectively. The optimal threshold for ΔSVLRM was 30% (sensitivity, 92.3%; specificity, 70.6%). With the gray zone approach, the inconclusive values ranged 25 to 75% for ΔSVLRM (including 50% of enrolled patients). Conclusion In prone position, LRM-induced SV decrease predicted SV increase after FL with higher reliability than traditional dynamic indices. On the other hand, considering the relatively large gray zone in this study, future research is needed to further improve the clinical significance. Trial registration UMIN Clinical Trial Registry UMIN000027966 . Registered 28th June 2017.Ryota WatanabeKoichi SuehiroAkira MukaiKatsuaki TanakaTokuhiro YamadaTakashi MoriKiyonobu NishikawaBMCarticleLung recruitment maneuverProne positionFluid responsivenessStroke volumeAnesthesiologyRD78.3-87.3ENBMC Anesthesiology, Vol 21, Iss 1, Pp 1-9 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Lung recruitment maneuver Prone position Fluid responsiveness Stroke volume Anesthesiology RD78.3-87.3
spellingShingle	Lung recruitment maneuver Prone position Fluid responsiveness Stroke volume Anesthesiology RD78.3-87.3 Ryota Watanabe Koichi Suehiro Akira Mukai Katsuaki Tanaka Tokuhiro Yamada Takashi Mori Kiyonobu Nishikawa Changes in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position
description	Abstract Background The present study aimed to evaluate the reliability of hemodynamic changes induced by lung recruitment maneuver (LRM) in predicting stroke volume (SV) increase after fluid loading (FL) in prone position. Methods Thirty patients undergoing spine surgery in prone position were enrolled. Lung-protective ventilation (tidal volume, 6–7 mL/kg; positive end-expiratory pressure, 5 cmH2O) was provided to all patients. LRM (30 cmH2O for 30 s) was performed. Hemodynamic variables including mean arterial pressure (MAP), heart rate, SV, SV variation (SVV), and pulse pressure variation (PPV) were simultaneously recorded before, during, and at 5 min after LRM and after FL (250 mL in 10 min). Receiver operating characteristic curves were generated to evaluate the predictability of SVV, PPV, and SV decrease by LRM (ΔSVLRM) for SV responders (SV increase after FL > 10%). The gray zone approach was applied for ΔSVLRM. Results Areas under the curve (AUCs) for ΔSVLRM, SVV, and PPV to predict SV responders were 0.778 (95% confidence interval: 0.590–0.909), 0.563 (0.371–0.743), and 0.502 (0.315–0.689), respectively. The optimal threshold for ΔSVLRM was 30% (sensitivity, 92.3%; specificity, 70.6%). With the gray zone approach, the inconclusive values ranged 25 to 75% for ΔSVLRM (including 50% of enrolled patients). Conclusion In prone position, LRM-induced SV decrease predicted SV increase after FL with higher reliability than traditional dynamic indices. On the other hand, considering the relatively large gray zone in this study, future research is needed to further improve the clinical significance. Trial registration UMIN Clinical Trial Registry UMIN000027966 . Registered 28th June 2017.
format	article
author	Ryota Watanabe Koichi Suehiro Akira Mukai Katsuaki Tanaka Tokuhiro Yamada Takashi Mori Kiyonobu Nishikawa
author_facet	Ryota Watanabe Koichi Suehiro Akira Mukai Katsuaki Tanaka Tokuhiro Yamada Takashi Mori Kiyonobu Nishikawa
author_sort	Ryota Watanabe
title	Changes in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position
title_short	Changes in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position
title_full	Changes in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position
title_fullStr	Changes in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position
title_full_unstemmed	Changes in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position
title_sort	changes in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position
publisher	BMC
publishDate	2021
url	https://doaj.org/article/b1c086d7970d45a397a48b5928df5018
work_keys_str_mv	AT ryotawatanabe changesinstrokevolumeinducedbylungrecruitmentmaneuvercanpredictfluidresponsivenessduringintraoperativelungprotectiveventilationinproneposition AT koichisuehiro changesinstrokevolumeinducedbylungrecruitmentmaneuvercanpredictfluidresponsivenessduringintraoperativelungprotectiveventilationinproneposition AT akiramukai changesinstrokevolumeinducedbylungrecruitmentmaneuvercanpredictfluidresponsivenessduringintraoperativelungprotectiveventilationinproneposition AT katsuakitanaka changesinstrokevolumeinducedbylungrecruitmentmaneuvercanpredictfluidresponsivenessduringintraoperativelungprotectiveventilationinproneposition AT tokuhiroyamada changesinstrokevolumeinducedbylungrecruitmentmaneuvercanpredictfluidresponsivenessduringintraoperativelungprotectiveventilationinproneposition AT takashimori changesinstrokevolumeinducedbylungrecruitmentmaneuvercanpredictfluidresponsivenessduringintraoperativelungprotectiveventilationinproneposition AT kiyonobunishikawa changesinstrokevolumeinducedbylungrecruitmentmaneuvercanpredictfluidresponsivenessduringintraoperativelungprotectiveventilationinproneposition
_version_	1718372214335602688

Changes in stroke volume induced by lung recruitment maneuver can predict fluid responsiveness during intraoperative lung-protective ventilation in prone position

Ejemplares similares