Dataset Information

Agreement between distal and forearm radial arterial pressures in patients undergoing prone spinal surgery: a prospective, self-controlled, observational study.

ABSTRACT:

Objective

To test agreement and interchangeability between distal (dRA) and forearm radial arterial (RA) pressures (AP) during general anesthesia (GA) for prone spinal surgery.

Methods

This prospective observational study involved 40 patients scheduled for GA spinal surgery. The right dRA and left forearm RA were cannulated in all patients to continuously measure invasive blood pressures (IBP). We compared the agreement and trending ability of systolic AP (SAP), diastolic AP (DAP), and mean AP (MAP) at each site 15 minutes after tracheal intubation, start of surgery, 30 and 60 minutes after the start of surgery, and after skin suturing.

Results

Paired BP values (n = 184) (37 cases) were analyzed. The bias (standard deviation), limits of agreement, and percentage error were: SAP: 0.19 (3.03), -5.75 to 6.12, and 5.04%; DAP: -0.06 (1.75), -3.50 to 3.38, and 5.10%; and MAP: 0.08 (1.52), -2.90 to 3.05, and 3.54%, respectively. The linear regression coefficients of determination were 0.981, 0.982, and 0.988 for SAPs, DAPs, and MAPs, respectively; four-quadrant plot concordance rates were 95.11%, 92.03%, and 92.66%, respectively.

Conclusion

All arterial BPs showed good agreement and trending capabilities for both the dRA and RA. The dRA may be substituted for the RA in IBP monitoring.

SUBMITTER: Xiong J

PROVIDER: S-EPMC10469259 | biostudies-literature | 2023 Aug

REPOSITORIES: biostudies-literature

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Publications

Agreement between distal and forearm radial arterial pressures in patients undergoing prone spinal surgery: a prospective, self-controlled, observational study.

Xiong Jingwei J Xu Miaomiao M Hui Kangli K Zhou Jiejie J Zhang Jie J Duan Manlin M Zhang Lidong L

The Journal of international medical research 20230801 8

<h4>Objective</h4>To test agreement and interchangeability between distal (dRA) and forearm radial arterial (RA) pressures (AP) during general anesthesia (GA) for prone spinal surgery.<h4>Methods</h4>This prospective observational study involved 40 patients scheduled for GA spinal surgery. The right dRA and left forearm RA were cannulated in all patients to continuously measure invasive blood pressures (IBP). We compared the agreement and trending ability of systolic AP (SAP), diastolic AP (DAP) ...[more]

PMID: 37646630

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Project description:Background and Objectives: Supine-to-prone hypotension is caused by increased intrathoracic pressure and decreased venous return in the prone position. Dynamic arterial elastance (Eadyn) indicates fluid responsiveness and can be used to predict hypotension. This study aimed to investigate whether Eadyn can predict supine-to-prone hypotension. Materials and Methods: In this prospective, observational study, 47 patients who underwent elective spine surgery in the prone position were enrolled. Supine-to-prone hypotension is defined as a decrease in Mean Arterial Pressure (MAP) by more than 20% in the prone position compared to the supine position. Hemodynamic parameters, including systolic blood pressure (SAP), diastolic blood pressure, MAP, stroke volume variation (SVV), pulse pressure variation (PPV), stroke volume index, cardiac index, dP/dt, and hypotension prediction index (HPI), were collected in the supine and prone positions. Supine-to-prone hypotension was also assessed using two different definitions: MAPprone < 65 mmHg and SAPprone < 100 mmHg. Hemodynamic parameters were analyzed to determine the predictability of supine-to-prone hypotension. Results: Supine-to-prone hypotension occurred in 13 (27.7%) patients. Eadyn did not predict supine-to-prone hypotension [Area under the curve (AUC), 0.569; p = 0.440]. SAPsupine > 139 mmHg (AUC, 0.760; p = 0.003) and dP/dtsupine > 981 mmHg/s (AUC, 0.765; p = 0.002) predicted supine-to-prone hypotension. MAPsupine, SAPsupine, PPVsupine, and HPIsupine predicted MAPprone <65 mm Hg. MAPsupine, SAPsupine, SVVsupine, PPVsupine, and HPIsupine predicted SAPprone < 100 mm Hg. Conclusions: Dynamic arterial elastance did not predict supine-to-prone hypotension in patients undergoing spine surgery. Systolic arterial pressure > 139 mmHg and dP/dt > 981 mmHg/s in the supine position were predictors for supine-to-prone hypotension. When different definitions were employed (mean arterial pressure < 65 mmHg in the prone position or systolic arterial pressure < 100 mmHg in the prone position), low blood pressures in the supine position were related to supine-to-prone hypotension.

Dataset Information

Agreement between distal and forearm radial arterial pressures in patients undergoing prone spinal surgery: a prospective, self-controlled, observational study.

Objective

Methods

Results

Conclusion

Publications

Agreement between distal and forearm radial arterial pressures in patients undergoing prone spinal surgery: a prospective, self-controlled, observational study.

Similar Datasets

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