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Clinical Efficacy of Ultrasound-Assisted Scoliosis-Specific Exercise in Mild-Grade Adolescent Idiopathic Scoliosis
07:01

Clinical Efficacy of Ultrasound-Assisted Scoliosis-Specific Exercise in Mild-Grade Adolescent Idiopathic Scoliosis

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Changes in cardiac index and blood pressure on positioning children prone for scoliosis surgery

Z E Brown1, M Görges, E Cooke

  • 1Department of Anesthesiology, Pharmacology & Therapeutic, The University of British Columbia, Vancouver, British Columbia, Canada.

Anaesthesia
|May 29, 2013
PubMed

Insights

Prone positioning for scoliosis surgery significantly reduces cardiac index in adolescents by 18.5%. Mean arterial pressure remained stable, highlighting a need for strategies to manage this cardiac index decrease.

Area of Science:

  • Anesthesiology
  • Pediatric Surgery
  • Cardiovascular Physiology

Background:

  • Scoliosis correction surgery is common in adolescents.
  • Prone positioning is a critical surgical step.
  • Hemodynamic changes during prone positioning require investigation.

Purpose of the Study:

  • To investigate changes in cardiac index and mean arterial pressure in children during prone positioning for scoliosis surgery.
  • To assess the impact of prone positioning on pediatric cardiovascular function.

Main Methods:

  • Prospective observational study of 30 children (13-18 years) undergoing idiopathic scoliosis repair.
  • Measured cardiac index and mean arterial pressure at baseline, after fluid bolus, and after prone positioning.
  • Statistical analysis of hemodynamic parameters.

Main Results:

  • Prone positioning caused a median reduction in cardiac index of 18.5% (0.5 l.min(-1).m(-2)), with significant inter-subject variability.
  • Mean arterial blood pressure changes were not statistically significant.
  • A 5-ml.kg(-1) fluid bolus did not significantly alter baseline hemodynamics before prone positioning.

Conclusions:

  • Prone positioning leads to a significant decrease in cardiac index in pediatric patients undergoing scoliosis surgery.
  • Current fluid management strategies may not fully mitigate this reduction.
  • Development of predictive, preventive, and treatment strategies for decreased cardiac index is necessary.

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