Evaluation of pre-induction dynamic arterial elastance as an adjustable predictor of post-induction hypotension: A prospective observational study - 26/04/23
Abstract |
Study objective |
Dynamic arterial elastance (Eadyn) has been suggested as a functional measure of arterial load. We aimed to evaluate whether pre-induction Eadyn can predict post-induction hypotension.
Design |
Prospective observational study.
Patients |
Adult patients undergoing general anesthesia with invasive and non-invasive arterial pressure monitoring systems.
Measurements |
We collected invasive and non-invasive Eadyns (n = 38 in each), respectively. In both invasive and non-invasive Eadyns, pre-induction Eadyns were obtained during one-minute tidal and deep breathing in each patient before anesthetic induction. Post-induction hypotension was defined as a decrease of >30% in mean blood pressure from the baseline value or any absolute mean blood pressure value of <65 mmHg for 10 min after anesthetic induction. The predictabilities of Eadyns for the development of post-induction hypotension were tested using receiver-operating characteristic curve analysis.
Main results |
Invasive Eadyn during deep breathing showed significant predictability with an area under the curve (AUC) of 0.78 (95% Confidence interval [CI], 0.61–0.90, P = 0.001). But non-invasive Eadyn during tidal breathing (AUC = 0.66, 95% CI, 0.49–0.81, P = 0.096) and deep breathing (AUC = 0.53, 95% CI, 0.36–0.70, P = 0.75), and invasive Eadyn during tidal breathing (AUC = 0.66, 95% CI, 0.41–0.74, P = 0.095) failed to predict post-induction hypotension.
Conclusion |
In our study, invasive pre-induction Eadyn during deep breathing -could predict post-induction hypotension. Despite its invasiveness, future studies will be needed to evaluate the usefulness of Eadyn as a predictor of post-induction hypotension because it is an adjustable parameter.
Le texte complet de cet article est disponible en PDF.Highlights |
• | Post-induction hypotension develops frequently, with an incidence as high as 36.5%. |
• | Although, many studies have identified the predictors of post-induction hypotension, most predictors are not changeable. |
• | Dynamic arterial elastance measured invasively during deep breathing can predict post-induction hypotension. |
• | Despite its invasiveness, dynamic arterial elastance is useful, because it is an adjustable parameter. |
Keywords : Arterial load, Dynamic arterial elastance, General anesthesia, Post-induction hypotension, Pulse pressure variation (PPV), Stroke volume variation (SVV)
Plan
| ☆ | This study was presented in part at the 24th annual meeting of the Korean Society of Cardiothoracic and Vascular Anesthesiologists, April 10–11, 2021, Seoul, Korea. This study was registered in Clinical Research Information Service (cris.nih.go.kr; Identifier: KCT0005525). |
Vol 87
Article 111092- août 2023 Retour au numéro
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