Contemporary perioperative haemodynamic monitoring

Pang, Qianyun; Hendrickx, Jan F. A.; Liu, Hongliang; Poelaert, Jan

doi:10.5114/ait.2019.86279

Cited by 11 publications

(8 citation statements)

References 119 publications

(146 reference statements)

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“…Maintaining adequate CBF requires personalized hemodynamic treatment, basing on fluid regimen in fluid-responsive patients, inotropic support in subjects with compromised heart function and implementation of vasoactive agents in subjects with vasoplegia [ 58 ]. Goal-directed therapy is effective only if adequate methods of hemodynamic monitoring are applied [ 59 ]. These methods should be adjusted to individual patient’s needs and possible contraindications, taking into account preoperative risk of complications, the type and extent of surgery [ 60 ].…”

Section: Discussionmentioning

confidence: 99%

Investigating Association between Intraoperative Hypotension and Postoperative Neurocognitive Disorders in Non-Cardiac Surgery: A Comprehensive Review

Krzych

Pluta

Putowski

et al. 2020

JCM

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Postoperative delirium (POD) and postoperative cognitive decline (deficit) (POCD) are related to a higher risk of postoperative complications and long-term disability. Pathophysiology of POD and POCD is complex, elusive and multifactorial. Intraoperative hypotension (IOH) constitutes a frequent and vital health hazard in the perioperative period. Unfortunately, there are no international recommendations in terms of diagnostics and treatment of neurocognitive complications which may arise from hypotension-related hypoperfusion. Therefore, we performed a comprehensive review of the literature evaluating the association between IOH and POD/POCD in the non-cardiac setting. We have concluded that available data are quite inconsistent and there is a paucity of high-quality evidence convincing that IOH is a risk factor for POD/POCD development. Considerable heterogeneity between studies is the major limitation to set up reliable recommendations regarding intraoperative blood pressure management to protect the brain against hypotension-related hypoperfusion. Further well-designed and effectively-performed research is needed to elucidate true impact of intraoperative blood pressure variations on postoperative cognitive functioning.

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Section: Discussionmentioning

confidence: 99%

Investigating Association between Intraoperative Hypotension and Postoperative Neurocognitive Disorders in Non-Cardiac Surgery: A Comprehensive Review

Krzych

Pluta

Putowski

et al. 2020

JCM

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“…Moreover, withholding liquid administration may cause dehydration in patients, which increases the risk of hypotension during induction of anesthesia. Unfortunately, direct monitoring of hydration is impossible in the operating room, and only indirect hemodynamic parameters may be used to estimate patient hydration (Pang et al 2019 ; Szczepańska et al 2020 ). On the other hand, food and fluid restriction causes the stomach to empty, reducing the risk of pulmonary aspiration of gastric contents.…”

Section: Introductionmentioning

confidence: 99%

The influence of fasting and carbohydrate-enriched drink administration on body water amount and distribution: a volunteer randomized study

et al. 2021

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Background Fasting prior to anesthesia is considered aspiration prophylaxis. However, prolonged food and drink restrictions may increase the risk of other complications. The aim of this study was to assess whether a carbohydrate-enriched drink (Nutricia™ preOp®), recommended by the enhanced recovery after surgery (ERAS) protocol, can improve body hydration in fasting healthy individuals. Methods Measurements were done with the bioelectric impedance analysis with a Fresenius body composition monitor. Body composition, total body water, water distribution, and hemodynamic parameters were measured at the beginning of the study and after 10 h and 12 h of fasting. Patients fasted for 10 h and then were divided into two groups: the control (n = 40) and the pre-op group (n = 41). The pre-op group received 400 mL of Nutricia™ preOp®, as suggested in the ERAS guidance. The two-tailed Student’s t test was used to compare two groups with normally distributed data and homogenous variances; if variances were heterogeneous, Welch’s test was used. The Mann-Whitney U test was used to compare two groups with non-normal data distribution. p < 0.05 was considered statistically significant. Results We found no significant differences between the control and pre-op groups regarding body water distribution and body composition. We did not observe significant losses in the total body water after fasting. Also, blood pressure was not affected by fasting. Conclusion We have proven that pre-op did not impact either body composition or body water. Trial registration ClinicalTrials.gov, NCT04665349. Registered on 11 December 2020—retrospectively registered.

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“…Perioperative haemodynamic monitoring is the cornerstone of optimizing tissue perfusion and preventing metabolic deterioration. Hemodynamic instability is related to cardiac dysfunction ( Pang et al, 2019 ). Dexmedetomidine inhibits the release of norepinephrine through stimulating presynaptic and postsynaptic α 2 receptors, which in turn slows the patient’s heart rate and reduces blood pressure, and then maintain the stability of hemodynamics of patients ( Weerink et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

Analgesic Effects and Safety of Dexmedetomidine Added to Nalbuphine or Sufentanil Patient-Controlled Intravenous Analgesia for Children After Tonsillectomy Adenoidectomy

Jia

Wang

et al. 2022

Front. Pharmacol.

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Tonsillectomy is a frequently performed surgical procedure in children, requiring post-operative analgesia. This study evaluated the efficacy and safety of nalbuphine or sufentanil combined with dexmedetomidine for patient-controlled intravenous analgesia (PCIA) after pediatric tonsillectomy adenoidectomy. A total of 400 patients undergoing tonsillectomy with and without adenoidectomy were included in the study. Patients received a PCIA pump (0.5 mg/kg nalbuphine, 2 μg/kg dexmedetomidine and 0.9% sodium chloride to a total volume of 100 ml) for postoperative pain management were classified into Group ND (n = 200). Patients received a PCIA pump (2 μg/kg sufentanil, 2 μg/kg dexmedetomidine and 0.9% sodium chloride to a total volume of 100 ml) for postoperative pain management were classified into Group SD (n = 200). More stable hemodynamic changes were noted in Group ND than Group SD from 1 h to 48 h after operation. At 6, 12, 24, and 48 h after operation, the children in Group ND had higher Ramsay sedation scores than those in Group SD. The times to push the PCIA button in Group ND and Group SD were 2.44 ± 0.74 and 2.62 ± 1.00, showing significant differences (p = 0.041). The VASR scores of children in Group ND were significantly lower within 6, 12, and 24 h than those in Group SD (p < 0.05). The VASC scores of children in Group ND were significantly lower within four time points (2, 6, 12, and 24 h) than those in Group SD (p < 0.05). At 1st day after surgery, the children in Group ND had lower levels of serum ACTH, IL-6, and COR levels than those in Group SD (p < 0.001). The incidence rates of nausea and vomiting, and pruritus were significantly higher in Group SD than Group ND (5.00% vs. 11.00%, p = 0.028; 1.00% vs. 4.50%, p = 0.032). The total incidence rate of adverse reactions was significantly higher in Group SD than Group ND (15.00% vs. 31.00%, p = 0.0001). The study demonstrated that dexmedetomidine added to nalbuphine PCIA enhanced the analgesic effects, attenuated the postoperative pain, and reduced the stress response after pediatric tonsillectomy adenoidectomy.

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Contemporary perioperative haemodynamic monitoring

Cited by 11 publications

References 119 publications

Investigating Association between Intraoperative Hypotension and Postoperative Neurocognitive Disorders in Non-Cardiac Surgery: A Comprehensive Review

Investigating Association between Intraoperative Hypotension and Postoperative Neurocognitive Disorders in Non-Cardiac Surgery: A Comprehensive Review

The influence of fasting and carbohydrate-enriched drink administration on body water amount and distribution: a volunteer randomized study

Analgesic Effects and Safety of Dexmedetomidine Added to Nalbuphine or Sufentanil Patient-Controlled Intravenous Analgesia for Children After Tonsillectomy Adenoidectomy

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