Effect of Prone Positioning Systems on Hemodynamic and Cardiac Function During Lumbar Spine Surgery: An Echocardiographic Study

Abstract

Adequate fluid replacement reduced hypotension and hemodynamic instability after prone positioning. The Jackson spine table and longitudinal bolsters had minimal effects on cardiac function, and should be considered in patients with limited cardiac reserve.

Changes in the hemodynamic parameters between the prone and supine positions measured by an arterial pulse contour cardiac output monitoring system

“…In the current study, a longitudinal bolster device that partially supports the chest and pelvis, partially compresses the abdomen, and positions the legs above the heart was used. Consistent with the results of the present study, Dharmavaram et al [8] showed that the longitudinal bolster device has a minimal effect on the cardiac performance. Toyota and Amaki [7] reported that the patient's assumption of a flat prone position and the use of a longitudinal bolster device caused no changes in the hemodynamic parameters, such as the CI, SV, and SVRI.…”

“…Most of the previous relevant studies showed that the SV, CI [6], and blood pressure [7,8] decrease when patients are made to assume a prone position. When a patient assumes a prone position, the arterial pressure can remain stable, but the CO usually decreases due to the reduced venous return.…”

“…Regarding the frames, some suggested that the SV decreases when patients are placed on a convex saddle frame [6,8,12]. In the current study, a longitudinal bolster device that partially supports the chest and pelvis, partially compresses the abdomen, and positions the legs above the heart was used.…”

A transesophageal echocardiography examination clarifies the cause of cardiovascular collapse during scoliosis surgery in a child

“…[3][4][5] The most common abnormalities found were decreases in the cardiac index and stroke volume with preserved ejection fraction. These abnormalities are consistent with a decrease in venous return, possibly due to compression of the inferior vena cava.…”

Multiple Cerebellar Abscesses in a 6 Year Old with Uncorrected Congenital Heart Disease: Anaesthetic Challenges

“…Placing the patient prone was also a challenge during the management of this patient. Prone positioning has been found to decrease blood pressure and cardiac function during spine surgery however studies have found that adequate fluid replacement reduced the hypotension and hemodynamics instability in patients in prone position [10].…”