The ability of the Vigileo-FloTrac system to measure cardiac output and track cardiac output changes during one-lung ventilation

Suehiro, Koichi; Tanaka, Katsuaki; Yamada, Tokuhiro; Matsuura, Tadashi; Mori, Takashi; Funao, Tomoharu; Nishikawa, Kiyonobu

doi:10.1007/s10877-014-9609-z

Cited by 17 publications

(13 citation statements)

References 23 publications

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“…Dynamic indices, such as stroke volume variation, pulse pressure variation and the pleth variability index are known to be better predictors of fluid responsiveness than static indices in mechanically ventilated patients . Among these, pleth variability index is a novel marker, allowing for continuous and automated calculation of respiratory variations in the pulse oximetry waveform amplitude .…”

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confidence: 99%

Pleth variability index can predict spinal anaesthesia‐induced hypotension in patients undergoing caesarean delivery

Kuwata

Suehiro

Juri

et al. 2017

Acta Anaesthesiol Scand

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Background: Spinal anaesthesia carries a risk of hypotension. We hypothesized that pleth variability index and perfusion index would assess maternal volume status, and thus, allow identification of patients at higher risk of developing hypotension after spinal anaesthesia for caesarean delivery. Methods: Fifty patients undergoing elective caesarean delivery were enrolled. All patients received spinal anaesthesia with 0.5% hyperbaric bupivacaine (10 mg) and fentanyl (10 mcg). Blood pressure was measured every minute. Pleth variability index and perfusion index were automatically measured throughout the procedure using pulse oximetry on the index finger. In case of hypotension (systolic blood pressure below 90 mmHg or 80% of the baseline value), ephedrine 5 mg was administered. Receiveroperating characteristic and multivariate logistic regression analyses for spinal anaesthesia-induced hypotension were performed. Results: Hypotension occurred in 32 patients (64%). The areas under the receiver-operating characteristic curve were 0.751 (95% confidence interval: 0.597-0.904) for pleth variability index before anaesthesia, 0.793 (95% confidence interval: 0.655-0.930) for pleth variability index after anaesthesia and 0.731 (95% confidence interval: 0.570-0.892) for perfusion index change (percent change in perfusion index induced by spinal anaesthesia). The optimal threshold value of pleth variability index (after anaesthesia) for predicting hypotension was 18% (sensitivity: 78.1%, specificity: 83.3%). Pleth variability index after spinal anaesthesia was an independent factor for hypotension (odds ratio: 1.21, P = 0.041). Conclusions: Pleth variability index after spinal anaesthesia was a good predictor of spinal anaesthesia-induced hypotension in patients undergoing caesarean delivery. In addition, perfusion index change after spinal anaesthesia has the potential to predict hypotension.

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confidence: 99%

Pleth variability index can predict spinal anaesthesia‐induced hypotension in patients undergoing caesarean delivery

Kuwata

Suehiro

Juri

et al. 2017

Acta Anaesthesiol Scand

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“…The systematic literature search yielded 2586 records. After removing 703 duplicates and two retracted papers, we screened 1881 records and finally identified 45 studies that met the eligibility criteria [3, 15–58]. Four additional studies were identified through PubMed and Google Scholar searches and screening relevant articles' reference lists [59–62].…”

Section: Resultsmentioning

confidence: 99%

Effects of phenylephrine on systemic and cerebral circulations in humans: a systematic review with mechanistic explanations

Meng,

Sun,

Zhao

et al. 2023

Anaesthesia

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SummaryWe conducted a systematic review of the literature reporting phenylephrine‐induced changes in blood pressure, cardiac output, cerebral blood flow and cerebral tissue oxygen saturation as measured by near‐infrared spectroscopy in humans. We used the proportion change of the group mean values reported by the original studies in our analysis. Phenylephrine elevates blood pressure whilst concurrently inducing a reduction in cardiac output. Furthermore, despite increasing cerebral blood flow, it decreases cerebral tissue oxygen saturation. The extent of phenylephrine's influence on cardiac output (r = ‐0.54 and p = 0.09 in awake humans; r = ‐0.55 and p = 0.007 in anaesthetised humans), cerebral blood flow (r = 0.65 and p = 0.002 in awake humans; r = 0.80 and p = 0.003 in anaesthetised humans) and cerebral tissue oxygen saturation (r = ‐0.72 and p = 0.03 in awake humans; r = ‐0.24 and p = 0.48 in anaesthetised humans) appears closely linked to the magnitude of phenylephrine‐induced blood pressure changes. When comparing the effects of phenylephrine in awake and anaesthetised humans, we found no evidence of a significant difference in cardiac output, cerebral blood flow or cerebral tissue oxygen saturation. There was also no evidence of a significant difference in effect on systemic and cerebral circulations whether phenylephrine was given by bolus or infusion. We explore the underlying mechanisms driving the phenylephrine‐induced cardiac output reduction, cerebral blood flow increase and cerebral tissue oxygen saturation decrease. Individualised treatment approaches, close monitoring and consideration of potential risks and benefits remain vital to the safe and effective use of phenylephrine in acute care.

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“…While minimally invasive methods relying on arterial line waveform analysis in addition to biometric and demographic data to estimate stroke volume for an individual patient are becoming more widely available [ 54 ], their effectiveness outside of goal-directed fluid therapy in terms of a true and precise reading compared to an invasive method has been questioned [ 54 ]. Additionally, the ability of these monitors to perform in the setting of one-lung ventilation has shown discordance when compared to pulmonary artery catheter values [ 55 ]. This means that any calculation of oxygen delivery will be an estimate.…”

Section: Finding the Right Balancementioning

confidence: 99%

Hypoxemia During One-Lung Ventilation: Does It Really Matter?

Durkin

Romano

Egan

et al. 2021

Curr Anesthesiol Rep

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Purpose of Review Hypoxemia during one-lung ventilation, while decreasing in frequency, persists as an intraoperative challenge for anesthesiologists. Discerning when desaturation and resultant hypoxemia correlates to tissue hypoxia is challenging in the perioperative setting and requires a thorough understanding of the physiology of oxygen delivery and tissue utilization. Recent Findings Oxygen delivery is not directly correlated with peripheral oxygen saturation in patients undergoing one-lung ventilation, emphasizing the importance of hemoglobin concentration and cardiac output in avoiding tissue hypoxia. While healthy humans can tolerate acute hypoxemia without long-term consequences, there is a paucity of evidence from patients undergoing thoracic surgery. Increasingly recognized is the potential harm of hyperoxic states, particularly in the setting of complex patients with comorbid diseases. Summary Anesthesiologists are left to determine an acceptable oxygen saturation nadir that is individualized to the patient and procedure based on an understanding of oxygen supply, demand, and the consequences of interventions.

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The ability of the Vigileo-FloTrac system to measure cardiac output and track cardiac output changes during one-lung ventilation

Cited by 17 publications

References 23 publications

Pleth variability index can predict spinal anaesthesia‐induced hypotension in patients undergoing caesarean delivery

Pleth variability index can predict spinal anaesthesia‐induced hypotension in patients undergoing caesarean delivery

Effects of phenylephrine on systemic and cerebral circulations in humans: a systematic review with mechanistic explanations

Hypoxemia During One-Lung Ventilation: Does It Really Matter?

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