Comparing preoperative fasting and ultrasound-measured intravascular volume status in elective surgery, enhanced recovery patients versus inpatient, urgent surgery patients and the ability of IVC collapsibility to predict post-induction hypotension.

Autor:	Wrobel JR; UNC School of Medicine, Chapel Hill, NC, USA., Magin JC; UNC School of Medicine, Chapel Hill, NC, USA., Williams D; Duke University School of Medicine, Durham, NC, USA., An X; UNC School of Medicine, Chapel Hill, NC, USA., Acton JD; UNC School of Medicine, Chapel Hill, NC, USA., Doyal AS; UNC School of Medicine, Chapel Hill, NC, USA., Jia S; UNC School of Medicine, Chapel Hill, NC, USA., Krakowski JC; UNC School of Medicine, Chapel Hill, NC, USA., Serrano R; UNC School of Medicine, Chapel Hill, NC, USA., Grant SA; UNC School of Medicine, Chapel Hill, NC, USA., Flynn DN; UNC School of Medicine, Chapel Hill, NC, USA., McLean DJ; UNC School of Medicine, Chapel Hill, NC, USA.
Jazyk:	angličtina
Zdroj:	Journal of perioperative practice [J Perioper Pract] 2024 Nov; Vol. 34 (11), pp. 363-368. Date of Electronic Publication: 2023 Dec 27.
DOI:	10.1177/17504589231215932
Abstrakt:	Hypotension following induction of general anaesthesia has been shown to result in increased complications and mortality postoperatively. Patients admitted to the hospital undergoing urgent surgery are often fasted from fluids for significant periods compared to elective patients subject to Enhanced Recovery After Surgery protocols despite guidelines stating that a two-hour fast is sufficient. The aim of this prospective, observational study was to compare fasting times and intravascular volume status between elective surgery patients subject to enhanced recovery protocols and inpatient, urgent surgery patients and to assess differences in the incidence of post-induction hypotension. Fasting data was obtained by questionnaire in the preoperative area in addition to inferior vena cava collapsibility index, a non-invasive measure of intravascular volume. Blood pressure readings and drug administration for the ten minutes following induction were obtained from patients' charts. Inpatients undergoing urgent surgery were fasted significantly longer than enhanced recovery patients and had lower intravascular volume. However, no difference was found in the incidence of post-induction hypotension.
Databáze:	MEDLINE
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