Evaluation of Volume Status with Plethysmographic Variability Index and Vena Cava Inferior Diameter Before Sitting Position Oturur Pozisyon Öncesinde Pletismografik Değişkenlik İndeksi ve Vena Kava İnferior Çapı Ölçümleri ile Volüm Durumunun Değerlendirilmesi
Anestezi Dergisi, cilt.32, sa.3, ss.174-181, 2024 (Scopus, TRDizin)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 32 Sayı: 3
- Basım Tarihi: 2024
- Doi Numarası: 10.54875/jarss.2024.23500
- Dergi Adı: Anestezi Dergisi
- Derginin Tarandığı İndeksler: Scopus, TR DİZİN (ULAKBİM)
- Sayfa Sayıları: ss.174-181
- Anahtar Kelimeler: Fluid responsiveness, inferior vena cava diameter, passive leg raise, plethysmography, sitting position
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Sağlık Bilimleri Üniversitesi Adresli: Evet
Özet
Objective: Orthostatic hypotension is a frequently encountered problem after sitting position. The aim of our study was to evaluate the intravascular volume status with passive leg-raising maneuver (PLRM), vena cava inferior (VCI) diameter measurements and plethysmographic variability index- plethysmographic waveform amplitude (∆Ppleth) before sitting position and to investigate the effect of these on predicting hemodynamic changes that may develop after sitting position. Methods: Fifty-three patients undergoing arthroscopic shoulder surgery under general anesthesia, aged 18-65, ASA I-II, were included in this prospective study. Mechanical ventilation was commenced with tidal volume of 6-8 mL kg-1, 5 cm H2O of PEEP. Heart rates, blood pressure and manually measured plethysmographic waveform amplitudes were recorded and VCI-distensibility index (VCI-DI) was calculated. Measurements were repeated after performing PLRM. Correlation of hemodynamic changes, observed after patients were placed in sitting position, with VCI-DI and variations in the ∆Ppleth was evaluated. Results: After induction, VCI-DI was >18% in 19 (35.8%) of 53 patients and in 14 (73.7%) of these, VCI-DI decreased with PLRM. In 14 (93.3%) of 15 patients with ∆Ppleth >15% after induction, ∆Ppleth decreased after PLRM. The decrease in VCI-DI and ∆Ppleth with PLRM was statistically significant (p<0.001; p<0.001). Changes in VCI-DI were found to correlate with ∆Ppleth (p<0.001). When patients were placed in sitting position, there was a significant decrease in heart rate, systolic blood pressure, mean arterial pressure (p=0.031; p<0.001), and a significant increase in ∆Ppleth (p<0.001). Conclusion: Plethysmographic waveform amplitude after PLRM can be used to predict the volume status and hemodynamic response of patients undergoing shoulder surgery in sitting position.