Document Detail


Effect of prone positioning systems on hemodynamic and cardiac function during lumbar spine surgery: an echocardiographic study.
MedLine Citation:
PMID:  16721305     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
STUDY DESIGN: Prospective randomized study of patients undergoing spine surgery. OBJECTIVE: To compare changes in hemodynamic and cardiac function after prone positioning using different prone positioners. SUMMARY OF BACKGROUND DATA: Prone positioning decreases blood pressure and cardiac function. Several studies have evaluated changes in cardiac function after prone positioning, and linked them to reduced venous return and ventricular compliance. This study compares different prone positioners using transesophageal echocardiography, and determines their effect on cardiac function and hemodynamics. METHODS: After correction of fluid deficits with the patient under stable anesthesia, hemodynamic and cardiac performance was measured using transesophageal echocardiography. After prone positioning, repeat measurements were performed, and comparisons were made between prone and supine positions. RESULTS: No intergroup differences in demographics, fluid deficit, baseline hemodynamics, or differences from supine to prone position were noted. Cardiac output decreased with the Wilson (Union City, CA) and Siemens AG (Munich, Germany) frames, while cardiac index and stroke volume decreased with the Andrews (Hollywood, CA), Wilson, and Siemens systems. Cardiac preload decreased using the Andrews frame. The Jackson spine table (Hollywood, CA) and bolsters had the least effect on cardiac performance. CONCLUSION: Adequate fluid replacement reduced hypotension and hemodynamic instability after prone positioning. The Jackson spine table and longitudinal bolsters had minimal effects on cardiac function, and should be considered in patients with limited cardiac reserve.
Authors:
Sreenivasa Dharmavaram; W Scott Jellish; Russ P Nockels; John Shea; Rashid Mehmood; Alex Ghanayem; Bruce Kleinman; William Jacobs
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Publication Detail:
Type:  Journal Article; Randomized Controlled Trial    
Journal Detail:
Title:  Spine     Volume:  31     ISSN:  1528-1159     ISO Abbreviation:  Spine     Publication Date:  2006 May 
Date Detail:
Created Date:  2006-05-24     Completed Date:  2006-07-05     Revised Date:  2009-07-09    
Medline Journal Info:
Nlm Unique ID:  7610646     Medline TA:  Spine (Phila Pa 1976)     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1388-93; discussion 1394     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Loyola University Medical Center, Maywood, IL 60153, USA.
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MeSH Terms
Descriptor/Qualifier:
Adult
Blood Pressure
Cardiac Output
Echocardiography, Transesophageal
Female
Heart / physiopathology*
Heart Rate
Hemodynamics*
Humans
Lumbar Vertebrae / surgery*
Male
Middle Aged
Orthopedic Procedures*
Prone Position*
Stroke Volume
Supine Position

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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