scholarly journals Effects of different sufentanil target concentrations on the MACBAR of sevoflurane in patients with carbon dioxide pneumoperitoneum stimulus

2020 ◽  
Author(s):  
Yanxia Guo ◽  
Dan Wang ◽  
Xiao-lin Yang ◽  
Pingping Jiang ◽  
Juan Xu ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Cholecystectomy ◽  
Target Concentration ◽  
Sevoflurane Concentration ◽  
Carbon Dioxide Pneumoperitoneum ◽  
Adrenergic Response ◽  
Significant Difference ◽  
Plasma Target ◽  
Before And After ◽  
End Tidal

Abstract Background: This study aims to observe the effects of different target controlled plasma sufentanil concentrations on the minimum alveolar concentration (MAC) of sevoflurane for blocking adrenergic response (BAR) in patients undergoing laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum stimulation.Methods: Eighty-five patients undergoing laparoscopic cholecystectomy, aged 30-65 years, with American Society of Anesthesiologists physical status Ⅰ-Ⅱ, were enrolled in this study. All the patients were randomly divided into 5 groups (S0, S1, S2, S3, S4) with different sufentanil plasma target concentration (0.0, 0.1, 0.3, 0.5, 0.7 ng ml-1). Anesthesia was induced by inhalation of 8% sevoflurane in 100% oxygen, and 0.6 mg kg-1 of rocuronium was intravenously injected to facilitate the insertion of laryngeal mask airway. The end-tidal sevoflurane concentration and sufentanil plasma target concentration were adjusted according to respective preset value in each group. The hemodynamic response to pneumoperitoneum stimulus was observed after the end-tidal sevoflurane concentration had been maintained stable at least for 15 min. The MACBAR of sevoflurane was measured by a sequential method. Meanwhile, epinephrine (E) and norepinephrine (NE) concentrations in the blood were also determined before and after pneumoperitoneum stimulus in each group.Results: When the method of independent paired reversals was used, the MACBAR of sevoflurane in groups S0, S1, S2, S3, S4 was 5.333% (confidence interval [CI] 95%: 5.197-5.469%), 4.533% (95% CI:4.451-4.616%), 2.861% (95% CI:2.752-2.981%), 2.233% (95% CI:2.142-2.324%) and 2.139% (95% CI:2.057-2.219%), respectively. Meanwhile, when the isotonic regression analysis was used, the MACBAR of sevoflurane in groups S0, S1, S2, S3, S4 was 5.329% (95% CI:5.321-5.343%), 4.557% (95% CI:4.552-4.568%), 2.900% (95% CI:2.894-2.911%), 2.216% (95% CI:2.173-2.223%) and 2.171% (95%CI:2.165-2.183%), respectively. The MACBAR had no significant difference between group S3 and group S4 when using 0.5 and 0.7 ng ml-1 of sufentanil plasma target concentrations. No significant difference was found in the change of E or NE concentration between before and after pneumoperitoneum stimulation in each group.Conclusions: The MACBAR of sevoflurane can be decreased with increasing sufentanil plasma target concentrations. A capping effect of the decrease occurred at a sufentanil plasma target concentration of 0.5 ng ml-1. When the sympathetic adrenergic response was inhibited in half patients to pneumoperitoneum stimulation in each group, the changes of E and NE concentrations showed no significant differences.Trial registration: The study was registered at http://www.chictr.org.cn (ChiCTR1800015819, 23, April, 2018).

scholarly journals Effects of different sufentanil target concentrations on the MACBAR of sevoflurane in patients with carbon dioxide pneumoperitoneum stimulus

2020 ◽  
Author(s):  
Yanxia Guo ◽  
Dan Wang ◽  
Xiao-lin Yang ◽  
Pingping Jiang ◽  
Juan Xu ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Cholecystectomy ◽  
Target Concentration ◽  
Sevoflurane Concentration ◽  
Carbon Dioxide Pneumoperitoneum ◽  
Adrenergic Response ◽  
Significant Difference ◽  
Plasma Target ◽  
Before And After ◽  
End Tidal

Abstract Background:The objective of this study is to observe the effects of different target controlled plasma sufentanil concentrations on the minimum alveolar concentration (MAC) of sevoflurane for blocking adrenergic response (BAR) in patients undergoing laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum stimulation.Methods: Eighty-five patients undergoing laparoscopic cholecystectomy, aged 18-65 years, with American Society of Anaesthesiologists physical status Ⅰ-Ⅱ, were enrolled in this study. All the patients were randomly divided into 5 groups (S0, S1, S2, S3, S4) with different sufentanil plasma target concentration (0.0, 0.1, 0.3, 0.5, 0.7 ng ml-1). Anaesthesia was induced by inhalation of 8% sevoflurane in 100% oxygen, and 0.6 mg kg-1 of rocuronium was intravenously injected to facilitate the insertion of laryngeal mask airway. The end-tidal sevoflurane concentration and sufentanil plasma target concentration were adjusted according to respective preset value in each group. The hemodynamic response to pneumoperitoneum stimulus was observed after the end-tidal sevoflurane concentration had been maintained stable at least for 15 min. The MACBAR of sevoflurane was measured by a sequential method. Meanwhile, epinephrine and norepinephrine concentrations in the blood were also determined before and after pneumoperitoneum stimulus in each group.Results:The basic MACBAR of sevoflurane in group S0 was 5.33% (confidence interval[CI] 95%: 5.19-5.47%), which was decreased 15%, 46%, 58% and 60% by the infusion of sufentanil with 0.1, 0.3, 0.5 and 0.7 ng ml-1 plasma target concentration, respectively. But the decreased degree had no significant difference between 0.5 and 0.7 ng ml-1 of sufentanil plasma target concentrations. No significant difference was found in the change of epinephrine or norepinephrine concentration between before and after pneumoperitoneum stimulation in each group.Conclusions: The MACBAR of sevoflurane can be decreased with increasing sufentanil plasma target concentrations. A capping effect of the decrease occurred at a sufentanil plasma target concentration of 0.5 ng ml-1. When the sympathetic adrenergic response was inhibited in half patients to pneumoperitoneum stimulation in each group, the changes of epinephrine and norepinephrine concentrations showed no significant differences.Trial registration: The study was registered at http://www.chictr.org.cn (ChiCTR1800015819, 23, April, 2018) .

scholarly journals Effects of different sufentanil target concentrations on the MACBAR of sevoflurane in patients with carbon dioxide pneumoperitoneum stimulus

2020 ◽  
Author(s):  
Yanxia Guo ◽  
Dan Wang ◽  
Xiao-lin Yang ◽  
Pingping Jiang ◽  
Juan Xu ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Cholecystectomy ◽  
Target Concentration ◽  
Sevoflurane Concentration ◽  
Carbon Dioxide Pneumoperitoneum ◽  
Adrenergic Response ◽  
Significant Difference ◽  
Plasma Target ◽  
Before And After ◽  
End Tidal

Abstract Background: This study aims to observe the effects of different target controlled plasma sufentanil concentrations on the minimum alveolar concentration (MAC) of sevoflurane for blocking adrenergic response (BAR) in patients undergoing laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum stimulation.Methods: Eighty-five patients undergoing laparoscopic cholecystectomy, aged 30-65 years, with American Society of Anesthesiologists physical status Ⅰ-Ⅱ, were enrolled in this study. All the patients were randomly divided into 5 groups (S0, S1, S2, S3, S4) with different sufentanil plasma target concentration (0.0, 0.1, 0.3, 0.5, 0.7 ng ml-1). Anesthesia was induced by inhalation of 8% sevoflurane in 100% oxygen, and 0.6 mg kg-1 of rocuronium was intravenously injected to facilitate the insertion of a laryngeal mask airway. The end-tidal sevoflurane concentration and sufentanil plasma target concentration were adjusted according to respective preset value in each group. The hemodynamic response to pneumoperitoneum stimulus was observed after the end-tidal sevoflurane concentration had been maintained stable at least for 15 min. The MACBAR of sevoflurane was measured by a sequential method. Meanwhile, epinephrine (E) and norepinephrine (NE) concentrations in the blood were also determined before and after pneumoperitoneum stimulus in each group.Results: When the method of independent paired reversals was used, the MACBAR of sevoflurane in groups S0, S1, S2, S3, S4 was 5.333% (confidence interval [CI] 95%: 5.197-5.469%), 4.533% (95% CI: 4.451-4.616%), 2.861% (95% CI: 2.752-2.981%), 2.233% (95% CI: 2.142-2.324%) and 2.139% (95% CI: 2.057-2.219%), respectively. Meanwhile, when the isotonic regression analysis was used, the MACBAR of sevoflurane in groups S0, S1, S2, S3, S4 was 5.329% (95% CI: 5.321-5.343%), 4.557% (95% CI: 4.552-4.568%), 2.900% (95% CI: 2.894-2.911%), 2.216% (95% CI: 2.173-2.223%) and 2.171% (95% CI: 2.165-2.183%), respectively. The MACBAR was not significantly different between groups S3 and S4 when using 0.5 and 0.7 ng ml-1 of sufentanil plasma target concentrations. No significant difference was found in the change of E or NE concentration between before and after pneumoperitoneum stimulation in each group.Conclusions: The MACBAR of sevoflurane can be decreased with increasing sufentanil plasma target concentrations. A ceiling effect of the decrease occurred at a sufentanil plasma target concentration of 0.5 ng ml-1. When the sympathetic adrenergic response was inhibited in half of the patients to pneumoperitoneum stimulation in each group, the changes of E and NE concentrations showed no significant differences.Trial registration: The study was registered at http://www.chictr.org.cn (ChiCTR1800015819, 23, April, 2018).

scholarly journals Effects of different sufentanil target concentrations on the MACBAR of sevoflurane in patients with carbon dioxide pneumoperitoneum stimulus

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Yanxia Guo ◽  
Dan Wang ◽  
Xiaolin Yang ◽  
Pingping Jiang ◽  
Juan Xu ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Laparoscopic Cholecystectomy ◽  
Target Concentration ◽  
Sevoflurane Concentration ◽  
Link Type ◽  
Carbon Dioxide Pneumoperitoneum ◽  
Adrenergic Response ◽  
Plasma Target ◽  
Before And After ◽  
End Tidal

Abstract Background This study aims to observe the effects of different target controlled plasma sufentanil concentrations on the minimum alveolar concentration (MAC) of sevoflurane for blocking adrenergic response (BAR) in patients undergoing laparoscopic cholecystectomy with carbon dioxide pneumoperitoneum stimulation. Methods Eighty-five patients undergoing laparoscopic cholecystectomy, aged 30–65 years, with American Society of Anesthesiologists physical status I-II, were enrolled in this study. All the patients were randomly divided into 5 groups (S0, S1, S2, S3, S4) with different sufentanil plasma target concentration (0.0, 0.1, 0.3, 0.5, 0.7 ng ml− 1). Anesthesia was induced by inhalation of 8% sevoflurane in 100% oxygen, and 0.6 mg kg− 1 of rocuronium was intravenously injected to facilitate the insertion of a laryngeal mask airway. The end-tidal sevoflurane concentration and sufentanil plasma target concentration were adjusted according to respective preset value in each group. The hemodynamic response to pneumoperitoneum stimulus was observed after the end-tidal sevoflurane concentration had been maintained stable at least for 15 min. The MACBAR of sevoflurane was measured by a sequential method. Meanwhile, epinephrine (E) and norepinephrine (NE) concentrations in the blood were also determined before and after pneumoperitoneum stimulus in each group. Results When the method of independent paired reversals was used, the MACBAR of sevoflurane in groups S0, S1, S2, S3, S4 was 5.333% (confidence interval [CI] 95%: 5.197–5.469%), 4.533% (95% CI: 4.451–4.616%), 2.861% (95% CI: 2.752–2.981%), 2.233% (95% CI: 2.142–2.324%) and 2.139% (95% CI: 2.057–2.219%), respectively. Meanwhile, when the isotonic regression analysis was used, the MACBAR of sevoflurane in groups S0, S1, S2, S3, S4 was 5.329% (95% CI: 5.321–5.343%), 4.557% (95% CI: 4.552–4.568%), 2.900% (95% CI: 2.894–2.911%), 2.216% (95% CI: 2.173–2.223%) and 2.171% (95% CI: 2.165–2.183%), respectively. The MACBAR was not significantly different between groups S3 and S4 when using 0.5 and 0.7 ng ml− 1 of sufentanil plasma target concentrations. No significant difference was found in the change of E or NE concentration between before and after pneumoperitoneum stimulation in each group. Conclusions The MACBAR of sevoflurane can be decreased with increasing sufentanil plasma target concentrations. A ceiling effect of the decrease occurred at a sufentanil plasma target concentration of 0.5 ng ml− 1. When the sympathetic adrenergic response was inhibited in half of the patients to pneumoperitoneum stimulation in each group, the changes of E and NE concentrations showed no significant differences. Trial registration The study was registered at http://www.chictr.org.cn (ChiCTR1800015819, 23, April, 2018).

scholarly journals Effects of different plasma target concentrations of remifentanil on the MACBAR of sevoflurane in children with laparoscopic surgery

2021 ◽  
Author(s):  
Xiao-lin Yang ◽  
Dan Wang ◽  
Juan Xu ◽  
YanXia Guy ◽  
Ping-Ping Jiang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Minimum Alveolar Concentration ◽  
Laparoscopic Herniorrhaphy ◽  
Target Concentration ◽  
Sequential Method ◽  
Carbon Dioxide Pneumoperitoneum ◽  
Adrenergic Response ◽  
Significant Difference ◽  
Plasma Target ◽  
Before And After

Abstract BackgroundTo investigate the effects of different plasma target concentrations of remifentanil on the minimum alveolar concentration (MAC) for blocking adrenergic response (BAR) of sevoflurane in children with laparoscopic herniorrhaphy.MethodsSeventy five children with 3–7 years old scheduled for laparoscopic herniorrhaphy were randomly divided into group R0, group R1, and group R2 according to different remifentanil plasma target concentration (0, 1, and 2 ng/ml), respectively. The MACBAR of sevoflurane was determined by the up-and-down and sequential method in each group. The concentrations of epinephrine and noradrenaline were also determined at corresponding time points.ResultsIn groups R0, R1, and R2, the MACBAR of sevoflurane was (3.29 ± 0.17)%, (2.12 ± 0.10)% and (1.29 ± 0.11)%, respectively, and a significant difference was found among the three groups (P < 0.05). The changes of epinephrine and noradrenaline concentrations in each group before and after insufflation of carbon dioxide pneumoperitoneum showed no significant differences.ConclusionRemifentanil by target-controlled infusion can effectively reduce the MACBAR of sevoflurane during laparoscopic surgery in children. At a similar effect of MACBAR, both the changes of epinephrine and noradrenaline concentrations are not affected by the infusion of different remifentanil target concentrations.Trial registrationThe trial was registered in the China Clinical Trial Center(http://www.chictr.org.cn) in advance (the registry number is ChiCTR1800019393.).

scholarly journals Effects of different plasma target concentrations of remifentanil on the MACBAR of sevoflurane in children with laparoscopic surgery

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Dan Wang ◽  
Juan Xu ◽  
Xiao-Lin Yang ◽  
Yan-Xia Guo ◽  
Ping-Ping Jiang ◽  
...  
Keyword(s):  
Laparoscopic Surgery ◽  
Laparoscopic Herniorrhaphy ◽  
Sequential Method ◽  
Link Type ◽  
Carbon Dioxide Pneumoperitoneum ◽  
Adrenergic Response ◽  
Significant Difference ◽  
Child Patients ◽  
Plasma Target ◽  
Before And After

Abstract Background To investigate the effects of different plasma target concentrations of remifentanil on the minimum alveolar concentration (MAC) for blocking adrenergic response (BAR) of sevoflurane in children with laparoscopic herniorrhaphy. Methods Seventy-five children with 3-7 years old scheduled for laparoscopic herniorrhaphy were randomly divided into group R0, group R1, and group R2 according to different remifentanil plasma target concentration (0, 1, and 2 ngml-1), respectively. The MACBAR of sevoflurane was determined by the up-and-down and sequential method in each group. The concentrations of epinephrine and noradrenaline were also determined at corresponding time points. Results A total of 52 child patients were used among the anticipated 75 patients. In groups R0, R1, and R2, the MACBAR of sevoflurane was (3.29 ± 0.17) %, (2.12 ± 0.10) % and (1.29 ± 0.11) %, respectively, and a significant difference was found among the three groups (P<0.05). The changes of epinephrine and noradrenaline concentrations in each group before and after insufflation of carbon dioxide pneumoperitoneum showed no significant differences. Conclusion Remifentanil by target-controlled infusion can effectively reduce the MACBAR of sevoflurane during laparoscopic surgery in children. At a similar effect of MACBAR, both the changes of epinephrine and noradrenaline concentrations are not affected by the infusion of different remifentanil target concentrations. Trial registration The trial was registered at http://www.chictr.org.cn(ChiCTR1800019393, 8, Nov, 2018).

Split face comparative study of microneedling with platelet rich plasma versus Fractional carbon dioxide laser with platelet rich plasma in treatment of atrophic post acne scars

QJM ◽  
2021 ◽  
Vol 114 (Supplement_1) ◽  
Author(s):  
Mohamed Abd Elnaeem Sallam ◽  
Khaled El Zawahry ◽  
Abdul Rahman Muhammed Ali Mustafa
Keyword(s):  
Carbon Dioxide ◽  
Co2 Laser ◽  
Carbon Dioxide Laser ◽  
Platelet Rich Plasma ◽  
Fractional Co2 Laser ◽  
Acne Scars ◽  
Significant Difference ◽  
Before And After ◽  
The Face ◽  
Fractional Carbon Dioxide Laser

Abstract Background Acne scars, is a challenge for dermatologists, despite having multiple treatment modalities like microneedling, dermabrasion, Fractional CO2 Laser, dermal fillers, etc. However, monotherapy has been hardly satisfactory because of the polymorphism seen with the scars. Objective Comparison between microneedling with platelet rich plasma versus Fractional carbon dioxide laser with platelet rich plasma in treatment of atrophic post acne scars. Patients and methods This study was carried out in department of dermatology, venereology and andrology, in Kobry El-Kobba Military complex during the period (from September 2018 to July 2020 ) on 20 patients of both sexes aged from 20 to 60 years old presenting with Goodman and Baron Grade II, III, IV acne scars . Results The study revealed a statistically significant difference (p = 0.017) between Goodman and Baron scar grades on the right side of the face before and after treatment indicating that microneedling with platelet rich plasma was effective in improving acne scars. Also, there is a statistically significant difference (p = 0.010) between Goodman and Baron scar grades on the left side of the face before and after treatment, indicating that fractional CO2 laser with platelet rich plasma was effective in improving acne scars. Conclusion and recommendation Further controlled and randomized studies are needed to validate our findings in a larger cohort of patients and longer follow up. Also, number of sessions might be more than 3 sessions.

Ventilatory responses to carbon dioxide at low and high levels of oxygen are elevated after episodic hypoxia in men compared with women

2004 ◽  
Vol 97 (5) ◽  
pp. 1673-1680 ◽  
Author(s):  
Chris Morelli ◽  
M. Safwan Badr ◽  
Jason H. Mateika
Keyword(s):  
Carbon Dioxide ◽  
Ventilatory Response ◽  
Minute Ventilation ◽  
High Oxygen ◽  
Set Point ◽  
Ventilatory Responses ◽  
Episodic Hypoxia ◽  
Before And After ◽  
Oxygen Gas ◽  
End Tidal

We hypothesized that the acute ventilatory response to carbon dioxide in the presence of low and high levels of oxygen would increase to a greater extent in men compared with women after exposure to episodic hypoxia. Eleven healthy men and women of similar race, age, and body mass index completed a series of rebreathing trials before and after exposure to eight 4-min episodes of hypoxia. During the rebreathing trials, subjects initially hyperventilated to reduce the end-tidal partial pressure of carbon dioxide (PetCO2) below 25 Torr. Subjects then rebreathed from a bag containing a normocapnic (42 Torr), low (50 Torr), or high oxygen gas mixture (150 Torr). During the trials, PetCO2 increased while the selected level of oxygen was maintained. The point at which minute ventilation began to rise in a linear fashion as PetCO2 increased was considered to be the carbon dioxide set point. The ventilatory response below and above this point was determined. The results showed that the ventilatory response to carbon dioxide above the set point was increased in men compared with women before exposure to episodic hypoxia, independent of the oxygen level that was maintained during the rebreathing trials (50 Torr: men, 5.19 ± 0.82 vs. women, 4.70 ± 0.77 l·min−1·Torr−1; 150 Torr: men, 4.33 ± 1.15 vs. women, 3.21 ± 0.58 l·min−1·Torr−1). Moreover, relative to baseline measures, the ventilatory response to carbon dioxide in the presence of low and high oxygen levels increased to a greater extent in men compared with women after exposure to episodic hypoxia (50 Torr: men, 9.52 ± 1.40 vs. women, 5.97 ± 0.71 l·min−1·Torr−1; 150 Torr: men, 5.73 ± 0.81 vs. women, 3.83 ± 0.56 l·min−1·Torr−1). Thus we conclude that enhancement of the acute ventilatory response to carbon dioxide after episodic hypoxia is sex dependent.

scholarly journals Comparisons of the Nonlinear Relationship of Cerebral Blood Flow Response and Cerebral Vasomotor Reactivity to Carbon Dioxide under Hyperventilation between Postural Orthostatic Tachycardia Syndrome Patients and Healthy Subjects

2020 ◽  
Vol 9 (12) ◽  
pp. 4088
Author(s):  
Shyan-Lung Lin ◽  
Shoou-Jeng Yeh ◽  
Ching-Kun Chen ◽  
Yu-Liang Hsu ◽  
Chih-En Kuo ◽  
...  
Keyword(s):  
Carbon Dioxide ◽  
Blood Flow ◽  
Cerebral Blood Flow ◽  
Blood Flow Velocity ◽  
Cerebral Blood Flow Velocity ◽  
Postural Orthostatic Tachycardia Syndrome ◽  
Significant Difference ◽  
Cerebral Vasomotor Reactivity ◽  
End Tidal ◽  
Fitting Model

Postural orthostatic tachycardia syndrome (POTS) typically occurs in youths, and early accurate POTS diagnosis is challenging. A recent hypothesis suggests that upright cognitive impairment in POTS occurs because reduced cerebral blood flow velocity (CBFV) and cerebrovascular response to carbon dioxide (CO2) are nonlinear during transient changes in end-tidal CO2 (PETCO2). This novel study aimed to reveal the interaction between cerebral autoregulation and ventilatory control in POTS patients by using tilt table and hyperventilation to alter the CO2 tension between 10 and 30 mmHg. The cerebral blood flow velocity (CBFV), partial pressure of end-tidal carbon dioxide (PETCO2), and other cardiopulmonary signals were recorded for POTS patients and two healthy groups including those aged >45 years (Healthy-Elder) and aged <45 years (Healthy-Youth) throughout the experiment. Two nonlinear regression functions, Models I and II, were applied to evaluate their CBFV-PETCO2 relationship and cerebral vasomotor reactivity (CVMR). Among the estimated parameters, the curve-fitting Model I for CBFV and CVMR responses to CO2 for POTS patients demonstrated an observable dissimilarity in CBFVmax (p = 0.011), mid-PETCO2 (p = 0.013), and PETCO2 range (p = 0.023) compared with those of Healthy-Youth and in CBFVmax (p = 0.015) and CVMRmax compared with those of Healthy-Elder. With curve-fitting Model II for POTS patients, the fit parameters of curvilinear (p = 0.036) and PETCO2 level (p = 0.033) displayed significant difference in comparison with Healthy-Youth parameters; range of change (p = 0.042), PETCO2 level, and CBFVmax also displayed a significant difference in comparison with Healthy-Elder parameters. The results of this study contribute toward developing an early accurate diagnosis of impaired CBFV responses to CO2 for POTS patients.

scholarly journals Comparison of end-tidal carbon dioxide and point-of-care echocardiography for fluid response at the bedside

2019 ◽  
pp. 102490791987092 ◽  
Author(s):  
Semih Korkut ◽  
Erden Erol Ünlüer ◽  
Arif Karagöz ◽  
Karama Bouchaala Mnif ◽  
Emine Kadioğlu
Keyword(s):  
Carbon Dioxide ◽  
Cardiac Output ◽  
Point Of Care ◽  
Passive Leg Raising ◽  
Velocity Time Integral ◽  
Time Integral ◽  
End Tidal Carbon Dioxide ◽  
Before And After ◽  
End Tidal ◽  
Bedside Method

Purpose: In this study, we aimed to compare cardiac output, echocardiographic pulmonary velocity-time integral, and end-tidal carbon dioxide values before and after the passive leg raising maneuver in healthy volunteers. Methods: The Ethical Commission approved the study. A total of 36 volunteers were included after signed informed consent in our study. After 12 h of fasting, vital signs, cardiac output, pulmonary velocity-time integral, and end-tidal carbon dioxide were measured when the participants were lying supine. Then, participants’ legs were elevated to 45° passively, and all measurements were repeated. Pulmonary velocity-time integral was obtained in parasternal short-axis view with the aid of pulse Doppler. Pulmonary root measurements were recorded. Echocardiographic stroke volume and cardiac output were calculated. The differences between values of cardiac output, pulmonary velocity-time integral, and end-tidal carbon dioxide before and after passive leg raising were statistically compared. The level of significance was accepted as p < 0.05. Results: Significant differences were found between pre- and post-passive leg raising values of these three measurements. The effect of passive leg raising on pulmonary velocity-time integral measurements was greater. The change in end-tidal carbon dioxide was not correlated with either cardiac output or pulmonary velocity-time integral alteration. Conclusion: Our results showed that measurement of pulmonary velocity-time integral changes after passive leg raising is a more useful bedside method to predict fluid responsiveness than measurement of end-tidal carbon dioxide and cardiac output alteration.

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