Open AccessEffects of Crystalloid Preloading (20 ml/kg) on Hemodynamics in Relation to Postural Changes in Patients Undergoing Neurosurgical Procedures in Sitting Position
Author(s) -
M. S. Ranjith,
Prasanna Udupi Bidkar,
K. Narmadalakshmi,
Praveen Talawar
Publication year - 2018
Publication title -
journal of neurosciences in rural practice
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.331
H-Index - 22
eISSN - 0976-3147
pISSN - 0976-3155
DOI - 10.4103/jnrp.jnrp_371_17
Subject(s) - supine position , medicine , stroke volume , hemodynamics , sitting , anesthesia , cardiac output , cardiac index , central venous pressure , cardiology , heart rate , blood pressure , pathology
Background: Hemodynamic disturbances are common during positioning the patients from supine to sitting for neurosurgical procedures. The reported incidence of hypotension varies from 5% to 32%. The aim of the study was to study the effect of crystalloid preloading on hemodynamic parameters during positioning the patient from supine to sitting position. Materials and Methods: In this prospective observational trial, 20 patients were enrolled. Two patients had a patent foramen ovale on transesophageal echocardiography and were excluded from the study. All the patients received 20 ml/kg of crystalloid (Ringer's lactate) before initiation of positioning. Physiological hemodynamic parameters such as heart rate, mean arterial pressure, central venous pressure, cardiac output (CO), stroke volume variation (SVV), cardiac index (CI), stroke volume (SV), and maximum and minimum inferior vena caval diameter (IVCD) were recorded after induction, during positioning at 30°, 60° inclination of the operating table and after the final sitting position. Results: Hemodynamic parameters were well maintained during positioning of the patients from supine to sitting position. Crystalloid preloading prevented the hypotension during positioning. There were no significant changes in hemodynamic parameters such as CO, SVR, SVV, CI, and SV. We did not find any correlation with changes in IVCD with changes in CO. Conclusion: A volume of 20 ml/kg of crystalloid preloading before positioning the patient from supine to sitting position maintains the hemodynamic stability and avoids the vasopressor requirement.