Hemodynamics Instability, Prone Position
Conditions
Keywords
hemodynamics, prone position, cardiac output
Brief summary
Perioperative prone position may be associated with hemodynamic instability. The causes of instability have not yet been precisely elucidated. The aim of this study is to demonstrate physiological changes during prone positioning in healthy volunteers .
Detailed description
The prone position could decrease the cardiac index (CI), mainly due to reduction in stroke volume, with little changes in heart rate. Mean arterial pressure (MAP) could be maintained by increased systemic vascular resistance (SVR) in the majority of patients. The aim of this study is to describe hemodynamic changes in two different surgical prone positions in 10 healthy non-anesthetized volunteers (flat position and using a support system allowing a free abdomen) by non-invasive measurement of hemodynamics (ClearSight, Edwards) and indirectly evaluated intra-abdominal pressure using ultrasound. The ClearSight system provides advanced hemodynamic parameters (cardiac index CI, stroke volume SV, stroke volume variation SVV, systemic vascular resistance SVR, mean arterial pressure MAP) from a finger cuff.
Interventions
PROCEDUREprone position
Unsupported prone position with arms along the body in neutral position will be used first without any supportive device except support of heels with a soft cylindrical device, head will be held in a neutral position using prone head rest. After recording of all measered values, the prone position using the prone position support system will be tested. The support system allows free movement of the lower thorax and abdomenal wall, upper arms are elevated and angled in 90 degrees (in shoulders and elbows). Heels will be positioned at the level of the heart using a supportive cylindrical device. Head will be held in a neutral position using prone head rest.
Sponsors
University Hospital Hradec Kralove
Study design
Observational model
COHORT
Time perspective
PROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
Yes
Inclusion criteria
* age \>18 years, * American Society of Anesthesiologists (ASA) Physical Status Classification I * agreement with study participation
Exclusion criteria
* disagreement with study participation, * BMI over 40 * pregnancy
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Change in Cardiac Index | 5 minutes | after changing supine to prone position |
Secondary
| Measure | Time frame | Description |
|---|---|---|
| Changes in vena cava diameter | 5 minutes | after changing supine to prone position |
| Changes in vena jugularis diameter | 5 minutes | after changing supine to prone position |
| Changes in vena saphena diameter | 5 minutes | after changing supine to prone position |
| Changes in vena cephalica diameter | 5 minutes | after changing supine to prone position |
Countries
Czechia
Outcome results
None listed