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Does the systolic pressure variation change in the prone position?
Roger Marks1, Richard Silverman, Raul Fernandez
1Department of Anesthesiology, University of Miami, FL, USA. rmarks@med.miami.edu
Journal of Clinical Monitoring and Computing
|July 25, 2009
Summary
Systolic pressure variation (SPV) remains a reliable indicator of patient volume status, even when patients are repositioned to the prone position. This finding suggests current protective methods are effective in maintaining hemodynamic stability.
Area of Science:
- Anesthesiology
- Critical Care Medicine
- Surgical Monitoring
Background:
- Systolic pressure variation (SPV) is a key indicator for detecting hypovolemia.
- However, SPV can be affected by factors like lung compliance and tidal volume changes.
- Monitoring hemodynamics with SPV in the prone position is challenging due to potential impacts on venous return and lung compliance.
Purpose of the Study:
- To investigate if patient positioning to the prone position significantly alters SPV.
- To determine the reliability of SPV as a hemodynamic indicator in the prone position.
Main Methods:
- Arterial pressure waveforms were analyzed to measure SPV in 25 patients undergoing spine surgery.
- Exclusion criteria included age over 65, BMI over 30, and a history of lung disease.
- SPV was measured in both supine and prone positions, with comparisons made using the Paired Student's t-test (P<0.05).
Main Results:
- The mean SPV was 6.9+/-1.9 mmHg in the supine position and 7.0+/-1.8 mmHg in the prone position.
- No statistically significant difference was observed in SPV between the supine and prone positions.
Conclusions:
- SPV does not change significantly when patients are placed in the prone position.
- This suggests SPV can continue to be utilized for monitoring volume status in prone patients.
- The findings also imply that current methods for protecting the chest and abdomen in the prone position are effective in maintaining hemodynamic stability.
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