Vasopressin Levels in Major Head and Neck Surgery

1997 ◽  
Vol 76 (2) ◽  
pp. 87-94 ◽  
Author(s):  
Niels F. Jensen ◽  
Robert I. Block
Keyword(s):  
Head And Neck ◽  
Venous Pressure ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Volume Status ◽  
Intravascular Volume ◽  
Central Venous ◽  
Pressure Monitor ◽  
Intraoperative Care ◽  
Intravascular Volume Status

In an effort to further understand the perioperative intravascular volume status of major head and neck surgery patients, serum antidiuretic hormone (ADH) and osmolality levels were assessed at four perioperative junctures. Thirty-five major head and neck surgical patients were randomly selected for examination with placement of a central venous pressure monitor. Serum osmolality and serum vasopressin levels were obtained at four junctures perioperatively. ADH levels were lower both after patients were anesthetized and five hours into the procedure than at either baseline or 24 hours after the end of the procedure. ADH levels after patients were anesthetized did not differ from those at five hours into the procedure, nor did ADH levels at baseline differ from those 24 hours after the end of the procedure. In addition, osmolality levels did not change over time. Additional analyses examining relationships between preoperative, intraoperative, and postoperative characteristics and ADH levels after patients were anesthetized and five hours into the procedure, as well as changes from baseline at these times and the baseline levels themselves, detected no significant relationships. This study provides information about the perioperative intravascular volume status of major head and neck surgery patients which may be important to intraoperative care, especially to decisions regarding invasive intraoperative fluid monitoring. Specifically, the data provide additional evidence against the need for the routine placement of central venous catheters to guide fluid administration during major head and neck surgery.

A PROSPECTIVE OBSERVATIONAL STUDY TO ASSESS CORRELATION OF CAVAL AORTA INDEX WITH CENTRAL VENOUS PRESSURE FOR INTRAVASCULAR VOLUME ASSESSMENT IN PATIENTS UNDERGOING ENDOSCOPIC TRANSURETHERAL RESECTION OF PROSTATE (TURP)

2021 ◽  
pp. 10-12
Author(s):  
N. Senthil kumar ◽  
Jeya Pratheef Muthiah
Keyword(s):  
Prospective Observational Study ◽  
Inferior Vena ◽  
Venous Pressure ◽  
Vena Cava ◽  
Volume Status ◽  
Intravascular Volume ◽  
Central Venous ◽  
Sonographic Evaluation ◽  
Volume Assessment ◽  
The Mean

INTRODUCTION: There are various techniques for assessing the uid status such as clinical examination, central venous pressure (CVP) measurement, biochemical markers, bio impedance, continuous blood volume measurement, or sonographic inferior vena cava (IVC) diameter assessment. Sonographic evaluation of the IVC and Aorta diameter and its usefulness in evaluating the volume status are studied and documented. The sonographic evaluation of the IVC & Aorta can predict the volume status, this tool can assist anesthetist in rapid diagnosis and prompt resuscitation of patients developing TURP syndrome AIM OF THE STUDY: The aim & objective of this study is to assess the correlation of Caval Aorta index with CVP in intravascular volume assessment in patients undergoing endoscopic Trans Urethral Resection of Prostate (TURP) MATERIALS AND METHODS: The study is carried out in the Department of Anaesthesiology involving Department of Urology in Kanyakumari Government Medical College from January 2018 to June 2019. It is a Prospective observational study. To measure the IVC diameter USG machine probe is placed in the sub-xiphoid region to visualize the conuence of the hepatic veins draining the IVC. The maximum internal AP diameter of the Aorta(Ao) and maximum internal anterior-posterior (AP) diameter of the IVC is measured in the longitudinal plane. Fluid status will be measured by CVP and IVC/Ao index recorded before neuraxial block, after preload, at 5 min after intrathecal block, resection time at 0 min, every 15 min during the rst 30 min, then every 30 min, until the end of surgery. Outcome: Incidence of hypotension after spinal anesthesia in a cesarean section RESULTS: The mean IVC diameter at pre-operative is 15.20±1.42, and at 60 min, 75 min were 19.39±1.92, 20.03±1.76 which suggests that the size and shape of the inferior vena cava (IVC) is correlated to the CVP and circulating blood volume. In my study the mean Aortic diameter at 60 min, 75 min were 20.30±1.01 and 19.81±1.06 which is same as the preoperative level (19.72±1.18) and diameter. The mean CVP at pre-operative is 4.57±0.73, mean CVP at 60 min, 75 min were 7.57±0.82, 8.11±0.78 which denotes that CVP increases as the intravascular volume status increases. In our study mean IVC/Aortic index at pre-operative is 0.77±0.05 and the mean IVC/Aortic index at 15min, 30 min, 60 min, 75 min were 0.87±0.03, 0.90±0.04, 0.95±0.06, 1.01±0.05 which increases signicantly in increasing intravascular volume. The strong correlation between these two variable with Pearson formula ranging from 0.450-0.900. CONCLUSION: As Sonographic caval Ao index is very well correlated with CVP , IVC/Ao index is useful for the evaluation of preoperative and intraoperative volume status, especially in major surgeries with marked uid shift or blood loss and had the advantage of being noninvasive, safe, quick, and easy technique with no complications.

scholarly journals Ultrasound Measurement of Inferior Vena Cava Diameter versus Central Venous Pressure as a Tool of Assessment of Intravascular Volume in Adult ICU Patients

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
B B Ghobrial ◽  
A M Alansary ◽  
R M Aly ◽  
A M Bayoumy
Keyword(s):  
Central Venous Pressure ◽  
Critically Ill ◽  
Critically Ill Patients ◽  
Venous Pressure ◽  
Vena Cava ◽  
Volume Status ◽  
Ultrasound Measurement ◽  
Intravascular Volume ◽  
Central Venous ◽  
Collapsibility Index

Abstract Background Measurements of central venous pressure (CVP), pulmonary arterial catheterization, esophageal Doppler, ultrasound, and trans-esophageal echocardiography may be used to determine the volume status of critically ill patients. Appropriate interpretation of the information offered by hemodynamic monitoring requires the integration of several variables. Echocardiography is increasingly used as a first tool to identify a problem and help select initial treatment. To improve patient management and outcome, the clinician must understand the advantages and the limitations of the various tools and parameters used during ICU stay. Aim of the Work to assess the intravascular volume by comparing between IVC diameter, IVC collapsibility index by ultrasound with central venous pressure (CVP) in critically ill patients. Patients and Methods A clinical interventional study was carried out at department of intensive care at Ain Shams University hospitals – Cairo – Egypt., during a three months (from October 2017 till December 2017).This study was approved by Ethical Committee of Faculty of Medicine, Ain Shams University, including the informed consents which were obtained from either the patient or the closest family member. Results In our study the IVC Collapsibility Index correlated well with the Central Venous Pressure. The sensitivity and specificity of IVC Collapsibility to Central Venous Pressure were also found to be highly statistically significant. The change in IVC diameters were also found to be statistically significant when compared to Central Venous Pressure. Conclusion The IVC CI% can provide a useful guide for noninvasive intravascular volume status and an alternative to CVP measurement assessment in critically ill patients.

The efficacy of routine central venous monitoring in major head and neck surgery: A retrospective review

1995 ◽  
Vol 7 (2) ◽  
pp. 119-125 ◽  
Author(s):  
Niels F. Jensen ◽  
Michael M. Todd ◽  
Robert I. Block ◽  
Raymond L. Hegtvedt ◽  
Timothy M. McCulloch
Keyword(s):  
Head And Neck ◽  
Retrospective Review ◽  
Neck Surgery ◽  
Head And Neck Surgery ◽  
Central Venous

scholarly journals Frequent malpositions of peripherally inserted central venous catheters in patients undergoing head and neck surgery

2011 ◽  
Vol 58 (8) ◽  
pp. 709-713 ◽  
Author(s):  
Leonid Minkovich ◽  
George Djaiani ◽  
Stuart A. McCluskey ◽  
Nicholas Mitsakakis ◽  
Ralph W. Gilbert ◽  
...  
Keyword(s):  
Head And Neck ◽  
Neck Surgery ◽  
Central Venous Catheters ◽  
Head And Neck Surgery ◽  
Central Venous
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