Bioelectrical impedance analysis of body composition for the anesthetic induction dose of propofol in older patients
| Autor: | Amílcar Falcão, Patrício Soares-da-Silva, Humberto S Machado, Ana M. Araújo |
|---|---|
| Jazyk: | angličtina |
| Rok vydání: | 2019 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent Cross-sectional study Population Gas Chromatography-Mass Spectrometry Body Mass Index lcsh:RD78.3-87.3 03 medical and health sciences Young Adult 0302 clinical medicine Older patients 030202 anesthesiology Anesthesiology Electric Impedance Medicine Humans 030212 general & internal medicine education Propofol Aged Aged 80 and over education.field_of_study Dose-Response Relationship Drug Propofol induction dose Frailty business.industry Phase angle Body Weight Age Factors Middle Aged Anesthesiology and Pain Medicine Cross-Sectional Studies lcsh:Anesthesiology Anesthesia Body Composition Female business Bioelectrical impedance analysis Body mass index Anesthetics Intravenous medicine.drug Research Article |
| Zdroj: | Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) Agência para a Sociedade do Conhecimento (UMIC)-FCT-Sociedade da Informação instacron:RCAAP BMC Anesthesiology, Vol 19, Iss 1, Pp 1-9 (2019) BMC Anesthesiology |
| Popis: | Background Older people are currently the fastest growing segment of the worldwide population. The present study aimed to estimate propofol dose in older patients based on size descriptors measured by bioelectrical impedance analysis (BIA). Methods A cross sectional study in adult and older patients with body mass index equal to or lower than 35 kg/m2 was carried out. BIA and Clinical Frail Scale scoring were performed during pre-operative evaluation. Propofol infusion was started at 2000 mg/h until loss of consciousness (LOC) which was defined by “loss of eye-lash reflex” and “loss of response to name calling”. Total dose of propofol at LOC was recorded. Propofol plasma concentration was measured using gas chromatography/ion trap-mass spectrometry. Results Forty patients were enrolled in the study. Total propofol dose required to LOC was lower in Age ≥ 65 group and a higher plasma propofol concentration was measured in this group. 60% of old patients were classified as “apparently vulnerable” or “frail” and narrow phase angle values were associated with increasing vulnerability scores. In the Age ≥ 65 group, the correlation analysis showed that the relationship between propofol dose and total body weight (TBW) scaled by the corresponding phase angle value is stronger than the correlation between propofol dose and TBW or fat free mass (FFM). Conclusions This study demonstrates that weight-based reduction of propofol is suitable in older patients; however FFM was not seen to be more effective than TBW to predict the propofol induction dose in these patients. Guiding propofol induction dose according to baseline frailty score should also be considered to estimate individualized dosage profiles. Determination of phase angle value appears to be an easy and reliable tool to assess frailty in older patients. Trial registration ClinicalTrials.gov Identifier: NCT02713698. Registered on 23 February 2016. |
| Databáze: | OpenAIRE |
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