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Increase in Airway Pressure Resulting From Prone Position Patient Placing May Predict Intraoperative Surgical Blood Loss

 Jae Chul Koh  ;  Jong Seok Lee  ;  Dong Woo Han  ;  Satbyul Choi  ;  Chul Ho Chang 
 SPINE, Vol.38(11) : 678-682, 2013 
Journal Title
Issue Date
Aged ; Blood Loss, Surgical/physiopathology* ; Blood Pressure/physiology ; Epidural Space/blood supply ; Female ; Heart Rate/physiology ; Humans ; Hyperemia/physiopathology ; Intraoperative Period ; Lumbar Vertebrae/surgery* ; Male ; Middle Aged ; Orthopedic Procedures* ; Prone Position/physiology ; Prospective Studies ; Respiratory System/physiopathology* ; Risk Assessment ; Risk Factors
intraoperative blood loss ; lumbar spine surgery ; peak airway pressure ; plateau pressure ; prone position
STUDY DESIGN: Prospective study on intraoperative blood loss during lumbar spine surgery. OBJECTIVE: To evaluate the relationship between airway pressure change due to the patient's prone position and intraoperative blood loss during lumbar spine surgery. SUMMARY OF BACKGROUND DATA: A prone position may increase abdominal pressure. Changes in abdominal pressure may influence airway pressure and cause intraoperative blood loss as a result of epidural venous congestion. METHODS: Patients undergoing lumbar spine surgery were placed in a prone position after the administration of general anesthesia. Peak airway pressure, plateau pressure, mean blood pressure, and heart rate were measured 5 minutes after anesthesia induction and 15 minutes after being placed in a prone position. Intraoperative blood loss was measured at the end of surgery. RESULTS: Mean peak airway pressure was 13.7 ± 1.8 mm Hg while in a supine position and increased to 15.1 ± 2.5 mm Hg after placement in the prone position (P = 0.002). Plateau pressure was 12.6 ± 2.5 mm Hg while in a supine position and increased to 14.1 ± 1.9 mm Hg after placement in a prone position (P = 0.0002). Intraoperative blood loss was correlated with peak (R2 = 0.405) and plateau (R2 = 0.489) airway pressure changes. CONCLUSION: Increase in airway pressure resulting from placement into a prone position may predict intraoperative surgical blood loss.
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1. College of Medicine (의과대학) > Dept. of Anesthesiology and Pain Medicine (마취통증의학교실) > 1. Journal Papers
Yonsei Authors
Lee, Jong Seok(이종석) ORCID logo https://orcid.org/0000-0002-7945-2530
Chang, Chul Ho(장철호) ORCID logo https://orcid.org/0000-0001-5647-8298
Han, Dong Woo(한동우) ORCID logo https://orcid.org/0000-0002-8757-663X
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