"Grigore T. Popa" University of Medicine and Pharmacy, Iași, Romania.
Department of Anaesthesia and Intensive Care, Regional Institute of Oncology, Iași, Romania.
Anaesthesiol Intensive Ther. 2024;56(3):177-184. doi: 10.5114/ait.2024.142671.
Hypovolaemia is presumed to be a common risk factor of postinduction hypotension (PIH), despite worldwide improvement in preoperative volume optimization. Correct assessment of fluid status in patients undergoing general anaesthesia remains a major challenge for anaesthesiologists. Bioimpedance analysis (BIA) is a sensitive method that allows objective assessment of patient fluid status as it can detect subclinical changes. The study's main purpose was to determine the correlation between the preoperative BIA assessed fluid status and PIH.
This was an observational single centre study that included patients undergoing elective surgery. We defined PIH as the blood pressure decrease occurring during the first 10 minutes after induction of anaesthesia and orotracheal intubation before surgical incision. We standardized BIA evaluation, patient pre anaesthetic and preoperative preparation, technique and monitoring of anaesthesia.
Our study included 115 patients. The mean age of the population was 58.1 years and the median values for total and intracellular water were 35.1 L and 19.3 L, respectively. In the univariable and multivariable analysis, only total body and intracellular water were associated with different definitions of PIH. There was no correlation between any of the BIA-derived parameters of fluid status and the duration of PIH.
Our study shows that in elective surgery, bioimpedance could detect subtle, subclinical fluid parameters that are associated with PIH.
尽管全球范围内术前容量优化有所改善，但低血容量仍被认为是诱导后低血压（PIH）的常见危险因素。在全身麻醉下，正确评估患者的液体状态仍然是麻醉师面临的主要挑战。生物阻抗分析（BIA）是一种敏感的方法，可以客观评估患者的液体状态，因为它可以检测到亚临床变化。本研究的主要目的是确定术前 BIA 评估的液体状态与 PIH 之间的相关性。
这是一项观察性单中心研究，纳入了接受择期手术的患者。我们将 PIH 定义为麻醉诱导后和切开手术前气管插管期间发生的 10 分钟内血压下降。我们标准化了 BIA 评估、患者术前和术前准备、麻醉技术和监测。
我们的研究纳入了 115 名患者。人群的平均年龄为 58.1 岁，总水和细胞内水的中位数分别为 35.1 升和 19.3 升。在单变量和多变量分析中，只有总体水和细胞内水与不同的 PIH 定义相关。BIA 衍生的任何液体状态参数与 PIH 持续时间之间均无相关性。
我们的研究表明，在择期手术中，生物阻抗可以检测到与 PIH 相关的细微、亚临床的液体参数。
