title: Does targeted pre-load optimisation by stroke volume variation attenuate a reduction in cardiac output in the prone position.
abstract: The prone position can reduce cardiac output by up to 25% due to reduced preload. We hypothesised that preload optimisation targeted to stroke volume variation before turning prone might alleviate this. A supine threshold stroke volume variation of 14% in a preliminary study identified patients whose cardiac outputs would decline when turned prone. In 45 patients, cardiac output declined only in the group whose supine stroke volume variation was high (mean (SD) 5.1 (2.0) to 3.9 (1.9) l.min(-1) ; p < 0.001), but not in patients in whom it was low, or in those in whom stroke volume variation was high, but who received volume preload (p = 0.525 and 0.941, respectively). We conclude that targeted preload optimisation using a supine stroke volume variation value < 14% is effective in preventing falls in cardiac output induced by the prone position.
authors.affiliation: Department of Anesthesiology, National Taiwan University Hospital, Taipei, Taiwan.
authors.forename: C-Y
authors.initials: CY
authors.lastname: Wu
authors.forename: T-S
authors.initials: TS
authors.lastname: Lee
authors.forename: K-C
authors.initials: KC
authors.lastname: Chan
authors.forename: C-S
authors.initials: CS
authors.lastname: Jeng
authors.forename: Y-J
authors.initials: YJ
authors.lastname: Cheng
mesh_terms: D000328:Adult; D000368:Aged; D002302:Cardiac Output / Q000502:physiology; D005260:Female; D006439:Hemodynamics; D006801:Humans; D007430:Intraoperative Care / Q000379:methods*; D008159:Lumbar Vertebrae / Q000601:surgery; D008297:Male; D008875:Middle Aged; D056888:Patient Positioning / Q000009:adverse effects* / Q000379:methods; D010865:Pilot Projects; D057234:Preoperative Period; D016684:Prone Position / Q000502:physiology; D012680:Sensitivity and Specificity; D013318:Stroke Volume / Q000502:physiology*; D016683:Supine Position / Q000502:physiology; D055815:Young Adult