The effect of patient positions on perfusion index

Tapar, Hakan; Karaman, Serkan; Doğru, Serkan; Karaman, Tuğba; Şahin, Ali; Tapar, Gulsen Genc; Altıparmak, Fatih; Süren, Mustafa

doi:10.1186/s12871-018-0571-z

Cited by 34 publications

(33 citation statements)

References 17 publications

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“…Increased intra-abdominal pressure in prone position contributes to subsequent physiological changes such as decreased cardiac index, inferior vena caval obstruction, and pulmonary ventilation/perfusion distribution [28]. It is reported that compared with the supine position, the prone position adversely affects the PI values [29]. In the present study, no significant differences in SpHb data were noted between the supine and prone positions in the same patient.…”

Section: Discussionmentioning

confidence: 40%

Validity of accuracy and trending ability of non-invasive continuous total hemoglobin measurement in complex spine surgery: a prospective cohort study

2019

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Background Patients undergoing complex spine surgery present with multilevel spinal involvement, advanced age, and multiple comorbidities. Surgery is associated with significant blood loss and remarkable hemodynamic changes. The present study aimed to investigate the accuracy and trending ability of a non-invasive continuous method to monitor hemoglobin (SpHb) concentrations using a Radical-7™ Pulse CO-Oximeter in complex spine surgery. Methods Forty-nine patients who underwent complex spine surgery were enrolled in this prospective observational study. Multiple time points were established for data collection throughout the operation. Simultaneous SpHb–total hemoglobin (tHb) paired data were recorded for analyses. Linear regression analysis, Bland–Altman plot, four-quadrant plot, and Critchley polar plot were used to assess the accuracy and trending ability of the monitor. Results A total of 272 pairs of SpHb-tHb data were available and were divided into two groups based on the perfusion index (PI): PI values ≥1.0 ( n = 200) and PI values < 1.0 ( n = 72). The correction coefficients (r) between SpHb and tHb were 0.6946 and 0.6861 in the groups with PI values ≥1.0 and < 1.0, respectively ( P < 0000.1). In the ≥1.0 group, the mean bias was − 0.21 g/dL and the percentage error (PE) was 15.85%, whereas in the < 1.0 group, the mean bias was − 0.04 g/dL and the PE was 17.42%. Four-quadrant plot revealed a concordance rate of 85.11%, whereas the Critchley polar plot showed a concordance rate of 67.21%. Conclusions The present study demonstrates the acceptable accuracy of the Radical-7™ Pulse CO-Oximeter even with a low PI. However, the trending ability was limited and unsatisfactory.

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Section: Discussionmentioning

confidence: 40%

Validity of accuracy and trending ability of non-invasive continuous total hemoglobin measurement in complex spine surgery: a prospective cohort study

2019

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“…To take into account the postural, gravitationally induced effects on BP, it should be mentioned that the head-down Trendelenburg position leads to a temporary increase of venous return and preload, cardiac output and perfusion index [28]. Certainly, the stroke volume variation is subjected to the body posture [29,30], but the pressure hemodynamic effects, especially in people with hypotension, heart failure or aortic stenosis are the subject of dispute between various authors [31][32][33].…”

Section: Resultsmentioning

confidence: 99%

The Acute Hemodynamic Effects of Caffeine During Different Body Positions in Normotensive Young Adults

Iconaru¹,

Tantu²,

Tudor³

et al. 2020

Rev. Chim.

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The aim of this study was to investigate the acute cardiovascular hemodynamic effects of administration of a fixed dose of 130 mg of caffeine versus placebo in a sample of healthy young adults (N = 32, sex ratio 1/1), who were successively placed in four distinct positions (orthostatic before ingestion, orthostatic, supine and Trendelenburg vertical positions, after ingestion) on a gravitational inversion table. The experimental design was a single-center, parallel-group, doubleblind, randomized, placebo-controlled clinical trial. Following the descriptive and inferential statistical processing of the data, a statistical significant pattern (p <0.05) of acute postural cardiovascular hemodynamic adaptation of the subjects was revealed, under the influence of caffeine versus placebo ingestion.

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“…Moreover, parameters for evaluation of peripheral perfusion in the skin, including PPI, are increasingly being recommended as useful measures for body perfusion [19,20]. PPI is used as an indicator of peripheral perfusion in intensive care units [20,21] and operating theaters [4,22]. A recent study reported that monitoring PPI reflects changes in systemic hemodynamics during general anesthesia in a setting of changing preload conditions [4].…”

Section: Discussionmentioning

confidence: 99%

Effects of nitroglycerin versus labetalol on peripheral perfusion during deliberate hypotension for sinus endoscopic surgery: a randomized, controlled, double-blinded trial

et al. 2020

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Background: Deliberate hypotension is used to provide a bloodless field during functional endoscopic sinus surgery; however, the impact of controlled hypotension during anesthesia on peripheral tissue perfusion has not been extensively evaluated. The aim of this study was to compare the impact of nitroglycerin-versus labetalolinduced hypotension on peripheral perfusion. Methods: The present randomized, double-blinded, controlled trial included adult patients undergoing endoscopic sinus surgery. Patients were allocated to one of two groups according to the drug received for induction of deliberate hypotension: nitroglycerin (n = 20) or labetalol (n = 20). Mean arterial pressure was maintained at 55-65 mmHg in both groups. Both study groups were compared according to pulse oximeter-derived peripheral perfusion index (primary outcome), serum lactate level, mean arterial pressure, heart rate, surgical field score, and intraoperative blood loss. Results: Forty patients were included in the final analysis. The nitroglycerin group exhibited a higher peripheral perfusion index at nearly all records (p < 0.0001) and lower postoperative serum lactate levels (1.3 ± 0.2 mmol/L vs. 1.7 ± 0.4 mmol/L; p = 0.001) than the labetalol group. The peripheral perfusion index was higher in the nitroglycerin group than at baseline at most intraoperative readings. The median surgical field score was modestly lower in the labetalol group than in the nitroglycerin group in the first 20 min (2 [interquartile range (IQR) 2-2.5] versus 1.5 [IQR 1-2]; p = 0.001). Both groups demonstrated comparable and acceptable surgical field scores in all subsequent readings. Conclusion: Nitroglycerin-induced deliberate hypotension was accompanied by higher peripheral perfusion index and lower serum lactate levels than labetalol-induced deliberate hypotension during sinus endoscopic surgery.

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The effect of patient positions on perfusion index

Cited by 34 publications

References 17 publications

Validity of accuracy and trending ability of non-invasive continuous total hemoglobin measurement in complex spine surgery: a prospective cohort study

Validity of accuracy and trending ability of non-invasive continuous total hemoglobin measurement in complex spine surgery: a prospective cohort study

The Acute Hemodynamic Effects of Caffeine During Different Body Positions in Normotensive Young Adults

Effects of nitroglycerin versus labetalol on peripheral perfusion during deliberate hypotension for sinus endoscopic surgery: a randomized, controlled, double-blinded trial

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