Use of the cardiac power index to predict fluid responsiveness in the prone position: a proof-of-concept study.
| Autor: | Min JY; The Catholic University of Korea, College of Medicine, Eunpyeong St. Mary's Hospital, Department of Anesthesiology and Pain Medicine, Seoul, Republic of Korea., Jeon JP; The Catholic University of Korea, College of Medicine, Eunpyeong St. Mary's Hospital, Department of Anesthesiology and Pain Medicine, Seoul, Republic of Korea., Chung MY; The Catholic University of Korea, College of Medicine, Eunpyeong St. Mary's Hospital, Department of Anesthesiology and Pain Medicine, Seoul, Republic of Korea., Kim CJ; The Catholic University of Korea, College of Medicine, Eunpyeong St. Mary's Hospital, Department of Anesthesiology and Pain Medicine, Seoul, Republic of Korea. Electronic address: earlkain@catholic.ac.kr. |
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| Jazyk: | angličtina |
| Zdroj: | Brazilian journal of anesthesiology (Elsevier) [Braz J Anesthesiol] 2024 Nov-Dec; Vol. 74 (6), pp. 844545. Date of Electronic Publication: 2024 Aug 06. |
| DOI: | 10.1016/j.bjane.2024.844545 |
| Abstrakt: | Background: The primary aim of this proof-of-concept study was to investigate whether the Cardiac Power Index (CPI) could be a novel alternative method to assess fluid responsiveness in the prone position. Methods: Patients undergoing scheduled elective lumbar spine surgery in the prone position under general anesthesia were enrolled in the criteria of patients aged 19-75 years with American Society of Anesthesiologists (ASA) physical status I-II. The hemodynamic variables were evaluated before and after changes in posture after administering a colloid bolus (5 mL.kg -1 ) in the prone position. Fluid responsiveness was defined as an increase in the Stroke Volume Index (SVI) ≥ 10%. Results: A total of 28 patients were enrolled. In responders, the CPI (median [1/4Q-3/4Q]) decreased to 0.34 [0.28-0.39] W.m -2 (p = 0.035) after the prone position. After following fluid loading, CPI increased to 0.48 [0.37-0.52] W.m -2 (p < 0.008), and decreased SVI (median [1/4Q-3/4Q]) after prone increased from 26.0 [24.5-28.0] mL.m -2 to 33.0 [31.0-37.5] mL.m -2 (p = 0.014). Among non-responders, CPI decreased to 0.43 [0.28-0.53] W.m -2 (p = 0.011), and SVI decreased to 29.0 [23.5-34.8] mL.m -2 (p < 0.009). CPI exhibited predictive capabilities for fluid responsiveness as a receiver operating characteristic curve of 0.78 [95% Confidence Interval, 0.60-0.95; p = 0.025]. Conclusion: This study suggests the potential of CPI as an alternative method to existing preload indices in assessing fluid responsiveness in clinical scenarios, offering potential benefits for responders and non-responders. Competing Interests: Declaration of competing interest The authors declare no conflicts of interest. (Copyright © 2024 Sociedade Brasileira de Anestesiologia. Published by Elsevier España S.L.U. All rights reserved.) |
| Databáze: | MEDLINE |
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