Energy Expenditure Under General Anesthesia: An Observational Study Using Indirect Calorimetry in Patients Having Noncardiac Surgery.

Background: Perioperative hemodynamic management aims to optimize organ perfusion pressure and blood flow-assuming this ensures that oxygen delivery meets cellular metabolic needs. Cellular metabolic needs are reflected by energy expenditure. A better understanding of energy expenditure under general anesthesia could help tailor perioperative hemodynamic management to actual demands.

Chronic arterial hypertension and nocturnal non-dipping predict postinduction and intraoperative hypotension: A secondary analysis of a prospective study.

Study Objective: Postinduction and intraoperative hypotension are associated with organ injury in non-cardiac surgery patients. Automated ambulatory blood pressure monitoring can identify chronic arterial hypertension and nocturnal blood pressure non-dipping. We tested the hypotheses that: a) chronic arterial hypertension and nocturnal non-dipping are independent risk factors for postinduction and intraoperative hypotension; and b) adding information on chronic arterial hypertension and nocturnal non-dipping improves hypotension prediction models based on readily available preoperative clinical information.

[Intraoperative Hemodynamic Monitoring and Management].

Postoperative deaths are a consequence of postoperative complications - including acute kidney injury and myocardial injury. Postoperative complications are associated with non-modifiable patient-specific risk factors (i.e.

The Relation Between Mean Arterial Pressure and Cardiac Index in Major Abdominal Surgery Patients: A Prospective Observational Cohort Study.

Background: Cardiac output is an important hemodynamic variable and determines oxygen delivery. In contrast to blood pressure, cardiac output is rarely measured even in high-risk surgical patients, suggesting that clinicians consider blood pressure to be a reasonable indicator of systemic blood flow. However, the relationship depends on constant vascular tone and volume, both of which routinely vary during anesthesia and surgery.

Postoperative blood pressure management in patients treated in the ICU after noncardiac surgery.

Purpose Of Review: Blood pressure management is a cornerstone of hemodynamic management in patients treated in the ICU after noncardiac surgery. Postoperative blood pressure management is challenging, because blood pressure alterations after surgery can be profound and have numerous causes.

Recent Findings: Postoperative blood pressure alterations are common in patients treated in ICUs after noncardiac surgery.

Relationship Between Intraoperative and Preoperative Ambulatory Nighttime Heart Rates: A Secondary Analysis of a Prospective Observational Study.

Background: It remains unknown what constitutes physiologically relevant intraoperative bradycardia. Intraoperative bradycardia is usually defined using absolute heart rate thresholds, ignoring preoperative baseline heart rates. In contrast, we considered defining intraoperative bradycardia relative to preoperative ambulatory nighttime heart rate.

Agreement between continuous and intermittent pulmonary artery thermodilution for cardiac output measurement in perioperative and intensive care medicine: a systematic review and meta-analysis.

Background: Pulmonary artery thermodilution is the clinical reference method for cardiac output monitoring. Because both continuous and intermittent pulmonary artery thermodilution are used in clinical practice it is important to know whether cardiac output measurements by the two methods are clinically interchangeable.

Methods: We performed a systematic review and meta-analysis of clinical studies comparing cardiac output measurements assessed using continuous and intermittent pulmonary artery thermodilution in adult surgical and critically ill patients.

Agreement between continuous noninvasive finger cuff-derived and invasive arterial blood pressure measurements: Effect of data sampling and data processing.

Background: The effect of different methods for data sampling and data processing on the results of comparative statistical analyses in method comparison studies of continuous arterial blood pressure (AP) monitoring systems remains unknown.

Objective: We sought to investigate the effect of different methods for data sampling and data processing on the results of statistical analyses in method comparison studies of continuous AP monitoring systems.

Design: Prospective observational study.

Non-invasive measurement of pulse pressure variation using a finger-cuff method (CNAP system): a validation study in patients having neurosurgery.

The finger-cuff system CNAP (CNSystems Medizintechnik, Graz, Austria) allows non-invasive automated measurement of pulse pressure variation (PPV). We sought to validate the PPV-algorithm and investigate the agreement between PPV and arterial catheter-derived manually calculated pulse pressure variation (PPV). This was a prospective method comparison study in patients having neurosurgery.

Mechanisms contributing to hypotension after anesthetic induction with sufentanil, propofol, and rocuronium: a prospective observational study.

It remains unclear whether reduced myocardial contractility, venous dilation with decreased venous return, or arterial dilation with reduced systemic vascular resistance contribute most to hypotension after induction of general anesthesia. We sought to assess the relative contribution of various hemodynamic mechanisms to hypotension after induction of general anesthesia with sufentanil, propofol, and rocuronium. In this prospective observational study, we continuously recorded hemodynamic variables during anesthetic induction using a finger-cuff method in 92 non-cardiac surgery patients.

The effect of moderate intraoperative blood loss and norepinephrine therapy on sublingual microcirculatory perfusion in patients having open radical prostatectomy: An observational study.

Background: It is not clear whether moderate intraoperative blood loss and norepinephrine used to restore the macrocirculation impair the microcirculation and affect microcirculation/macrocirculation coherence.

Objective: We sought to investigate the effect of moderate intraoperative blood loss and norepinephrine therapy administered to treat intraoperative hypotension on the sublingual microcirculation.

Design: Prospective observational study.

Estimation of pulse pressure variation and cardiac output in patients having major abdominal surgery: a comparison between a mobile application for snapshot pulse wave analysis and invasive pulse wave analysis.

Pulse pressure variation (PPV) and cardiac output (CO) can guide perioperative fluid management. Capstesia (Galenic App, Vitoria-Gasteiz, Spain) is a mobile application for snapshot pulse wave analysis (PWAsnap) and estimates PPV and CO using pulse wave analysis of a snapshot of the arterial blood pressure waveform displayed on any patient monitor. We evaluated the PPV and CO measurement performance of PWAsnap in adults having major abdominal surgery.

Intraoperative hypotension: Pathophysiology, clinical relevance, and therapeutic approaches.

Intraoperative hypotension (IOH) i.e., low arterial blood pressure (AP) during surgery is common in patients having non-cardiac surgery under general anaesthesia.