Postural hemodynamic changes after turning to prone position
DOI:
https://doi.org/10.15587/2313-8416.2015.39269Keywords:
hemodynamics, supine position, prone position, thoracic rheography, body mass indexAbstract
Background of study. Prone position is one of the most complex positions for anesthesiologist as it is accompanied by several physiological changes that can lead to specific complications. Hemodynamic changes are most controversial.
Aim of study was to establish hemodynamic changes in non-anaesthetized patients in prone position depending on body mass index.
Material and methods. We examined central hemodynamics in 40 patients the day before surgery using thoracic rheography in supine position, in prone position 5 min after turning and in prone position 20 min after turning. Patients were divided into 2 groups according to body mass index (18-25 and 26-35).
Results. Patients with normal body weight did not have any hemodynamic changes after turning to prone position. Patients with increased body weight had higher cardiac index. After turning to prone position obese patients’ cardiac output and cardiac index reduced 22% comparing with supine position. After 20 min in prone position these hemodynamic parameters were found to be reduced to the same level.
Conclusion. Significant hemodynamic changes after turning from supine to prone position were revealed only in patients with increased body mass index. In these patients cardiac index in prone position was reduced by 22% comparing to supine position
References
Edgcombe, H., Carter, K., Yarrow, S. (2008). Anaesthesia in the prone position. British Journal of Anaesthesia, 100 (2), 165–183. doi: 10.1093/bja/aem380
Backofen, J. E., Backofen, S. J. (1985). Hemodynamic changes with prone positioning during general anesthesia. Anesth Analg., 64, 194.
Dharmavaram, S., Jellish, W. S., Nockels, R. P. et al. (2006). Effect of Prone Positioning Systems on Hemodynamic and Cardiac Function During Lumbar Spine Surgery: An Echocardiographic Study. Spine, 31 (12), 1388–1393. doi: 10.1097/01.brs.0000218485.96713.44
Hatada, T., Kusunoki, M., Sakiyama, T. et al. (1991). Hemodynamics in the prone jackknife position during surgery. The American Journal of Surgery, 162 (1), 55–58. doi: 10.1016/0002-9610(91)90202-o
Wadsworth, R., Anderton, J. M., Vohra, A. (1996). The effect of four different surgical prone positions on cardiovascular parameters in healthy volunteers. Anaesthesia, 51 (9), 819–822. doi: 10.1111/j.1365-2044.1996.tb12608.x
Sudheer, P. S., Logan, S. W., Ateleanu, B., Hall, J. E. (2006). Haemodynamic effects of the prone position: a comparison of propofol total intravenous and inhalation anaesthesia. Anaesthesia, 61 (2), 138–141. doi: 10.1111/j.1365-2044.2005.04464.x
Wu, C. Y., Lee, T. S., Chan, K. C. et al. (2012). Does targeted pre-load optimisation by stroke volume variation attenuate a reduction in cardiac output in the prone position. Anaesthesia, 67 (7), 760–764. doi: 10.1111/j.1365-2044.2012.07116.x
Yokoyama, M., Ueda, W., Hirakawa, M., Yamamoto, H. (1991). Hemodynamic effect of the prone position during anesthesia. Acta Anaesthesiologica Scandinavica, 35 (8), 741–744. doi: 10.1111/j.1399-6576.1991.tb03382.x
Toyota, S., Amaki, Y. (1998). Hemodynamic evaluation of the prone position by transesophageal echocardiography. Journal of Clinical Anesthesia, 10 (1), 32–35. doi: 10.1016/s0952-8180(97)00216-x
Leslie, K., Wu, C., Bjorksten, A. et al. (2011). Cardiac output and propofol concentrations in prone surgical patients. Anaesth Intensive Care, 39 (5), 868–874.
Schonauer, C., Bochetti, A., Barbagallo, G. et al. (2004). Positioning on surgical table. European Spine Journal, 13 (S01), 850–855. doi: 10.1007/s00586-004-0728-y
Park, C. K. (2000) The effect of patient positioning on intraabdominal pressure and blood loss in spinal surgery. Anesthesia & Analgesia, 91 (3), 552–557. doi: 10.1213/00000539-200009000-00009
Pump, B., Talleruphuus, U., Christensen, N. J. et al. (2002). Effects of supine, prone, and lateral positions on cardiovascular and renal variables in humans. American Journal of Physiology - Regulatory, Integrative and Comparative Physiology, 283 (1), 174–180. doi: 10.1152/ajpregu.00619.2001
Ozkose, Z., Ercan, B., Unal, Y. et al. (2001). Inhalation versus total intravenous anesthesia for lumbar disc herniation: comparison of hemodynamic effects, recovery characteristics, and cost. Journal of Neurosurgical Anesthesiology, 13 (4), 296–302.
Ho, J..D., Dawes, D. M., Moore, J. C. et al. (2011). Effect of position and weight force on inferior vena cava diameter--implications for arrest-related death / // Forensic Science International, 212 (1-3), 256–259. doi: 10.1016/j.forsciint.2011.07.001
Han, I. H., Son, D. W., Nam, K. H. et al. (2012). The effect of body mass index on intra-abdominal pressure and blood loss in lumbar spine surgery. Journal of Korean Neurosurgical Society, 51 (2), 81–85. doi: 10.3340/jkns.2012.51.2.81
Lee, T. C., Yang, L. C., Chen, H. J. (1998). Effect of patient position and hypotensive anesthesia on inferior vena caval pressure. Spine, 23 (8), 941–947. doi: 10.1097/00007632-199804150-00019
Downloads
Published
Issue
Section
License
Copyright (c) 2015 Микола Віталійович Лизогуб
This work is licensed under a Creative Commons Attribution 4.0 International License.
Our journal abides by the Creative Commons CC BY copyright rights and permissions for open access journals.
Authors, who are published in this journal, agree to the following conditions:
1. The authors reserve the right to authorship of the work and pass the first publication right of this work to the journal under the terms of a Creative Commons CC BY, which allows others to freely distribute the published research with the obligatory reference to the authors of the original work and the first publication of the work in this journal.
2. The authors have the right to conclude separate supplement agreements that relate to non-exclusive work distribution in the form in which it has been published by the journal (for example, to upload the work to the online storage of the journal or publish it as part of a monograph), provided that the reference to the first publication of the work in this journal is included.