Yassen Khaled Ahmed, Aljumaiy Walla, Alherz Imran, AlMudayris Lina A, AlBunyan Sara Abdulhameed, AlSubaie Renad S, Alniniya Fatma, Saleh Sherif
Anesthesia Unit, Surgery Department, College of Medicine, King Faisal University, Alahsa 31982, Saudi Arabia.
Anaesthesia Department, King Fahad Hospital, Hofuf 36441, Saudi Arabia.
J Clin Med. 2025 Mar 25;14(7):2228. doi: 10.3390/jcm14072228.
: Increased intra-abdominal pressure (IAP), autonomic reactions, and anesthetics all contribute to hemodynamic alterations during laparoscopic cholecystectomy. This study's objectives are to measure noninvasively the intraoperative individual responses in cardiac and systemic hemodynamics, focusing on cardiac output (CO. L/min), stroke volume (SV, mL/min), systemic vascular resistance (SVR, dyn.s.cm), and noninvasive mean arterial blood pressure (MABP, mmHg) during and after peritoneal insufflation (cmHO). The secondary objective was to evaluate the utility of EC as an adjunct to standard monitoring and to assess the individual differences. : The CO and associated parameters were continuously and noninvasively monitored with the electrical cardiometry (EC, ICON, Osypka, Berlin Germany). : Seventy-three patients showed that when the IAP increased to 13 [IQR: 13-14] cmHO, there was an overall percentage decrease in CO (-11.29%), MABP (-9.31%), and SVR (-23.16%) compared to pre induction with minimal changes in heart rate (HR). Individual variation and extreme reactions among certain patients were noted, with CO falling by -47.14% and MABP by -61.59, respectively, which can have major repercussions. : The EC enabled real-time, non-invasive CO monitoring and detected significant cardio-hemodynamic changes that conventional monitors could miss. EC can supplement traditional monitors and give attending anesthesiologists access to more of patients' vital information.
腹内压升高、自主神经反应和麻醉药均会导致腹腔镜胆囊切除术期间的血流动力学改变。本研究的目的是在气腹期间及气腹后(厘米水柱),以无创方式测量术中个体在心脏和全身血流动力学方面的反应,重点关注心输出量(CO,升/分钟)、每搏输出量(SV,毫升/分钟)、全身血管阻力(SVR,达因·秒/厘米)和无创平均动脉血压(MABP,毫米汞柱)。次要目的是评估电阻抗心动描记法(EC)作为标准监测辅助手段的效用,并评估个体差异。使用电阻抗心动描记法(EC,ICON,Osypka,德国柏林)对CO及相关参数进行连续无创监测。73例患者的研究结果显示,当腹内压升高至13[四分位间距:13 - 14]厘米水柱时,与诱导前相比,CO总体下降百分比为(-11.29%),MABP为(-9.31%),SVR为(-23.16%),心率(HR)变化极小。注意到某些患者存在个体差异和极端反应,CO分别下降了-47.14%,MABP下降了-61.59%,这可能会产生重大影响。电阻抗心动描记法能够进行实时无创CO监测,并检测到传统监测仪可能遗漏的显著心脏血流动力学变化。电阻抗心动描记法可以补充传统监测仪,并使麻醉主治医师能够获取更多患者的重要信息。