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The Impact of Individualized Hemodynamic Management on Intraoperative Fluid Balance and Hemodynamic Interventions during Spine Surgery in the Prone Position: A Prospective Randomized Trial

The result's identifiers

  • Result code in IS VaVaI

    <a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F00216208%3A11150%2F22%3A10452104" target="_blank" >RIV/00216208:11150/22:10452104 - isvavai.cz</a>

  • Alternative codes found

    RIV/00179906:_____/22:10452104

  • Result on the web

    <a href="https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=yQQhPyvzMP" target="_blank" >https://verso.is.cuni.cz/pub/verso.fpl?fname=obd_publikace_handle&handle=yQQhPyvzMP</a>

  • DOI - Digital Object Identifier

    <a href="http://dx.doi.org/10.3390/medicina58111683" target="_blank" >10.3390/medicina58111683</a>

Alternative languages

  • Result language

    angličtina

  • Original language name

    The Impact of Individualized Hemodynamic Management on Intraoperative Fluid Balance and Hemodynamic Interventions during Spine Surgery in the Prone Position: A Prospective Randomized Trial

  • Original language description

    Background and Objectives: The effect of individualized hemodynamic management on the intraoperative use of fluids and other hemodynamic interventions in patients undergoing spinal surgery in the prone position is controversial. This study aimed to evaluate how the use of individualized hemodynamic management based on extended continuous non-invasive hemodynamic monitoring modifies intraoperative hemodynamic interventions compared to conventional hemodynamic monitoring with intermittent non-invasive blood pressure measurements. Methods: Fifty adult patients (American Society of Anesthesiologists physical status I-III) who underwent spinal procedures in the prone position and were then managed with a restrictive fluid strategy were prospectively randomized into intervention and control groups. In the intervention group, individualized hemodynamic management followed a goal-directed protocol based on continuously non-invasively measured blood pressure, heart rate, cardiac output, systemic vascular resistance, and stroke volume variation. In the control group, patients were monitored using intermittent non-invasive blood pressure monitoring, and the choice of hemodynamic intervention was left to the discretion of the attending anesthesiologist. Results: In the intervention group, more hypotensive episodes (3 (2-4) vs. 1 (0-2), p = 0.0001), higher intraoperative dose of ephedrine (0 (0-10) vs. 0 (0-0) mg, p = 0.0008), and more positive fluid balance (680 (510-937) vs. 270 (196-377) ml, p &lt; 0.0001) were recorded. Intraoperative norepinephrine dose and postoperative outcomes did not differ between the groups. Conclusions: Individualized hemodynamic management based on data from extended non-invasive hemodynamic monitoring significantly modified intraoperative hemodynamic management and was associated with a higher number of hemodynamic interventions and a more positive fluid balance.

  • Czech name

  • Czech description

Classification

  • Type

    J<sub>imp</sub> - Article in a specialist periodical, which is included in the Web of Science database

  • CEP classification

  • OECD FORD branch

    30223 - Anaesthesiology

Result continuities

  • Project

  • Continuities

    I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Others

  • Publication year

    2022

  • Confidentiality

    S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Data specific for result type

  • Name of the periodical

    Medicina (Kaunas, Lithuania)

  • ISSN

    1010-660X

  • e-ISSN

    1648-9144

  • Volume of the periodical

    58

  • Issue of the periodical within the volume

    11

  • Country of publishing house

    LT - LITHUANIA

  • Number of pages

    11

  • Pages from-to

    1683

  • UT code for WoS article

    000895219100001

  • EID of the result in the Scopus database

    2-s2.0-85142650479