STUDY OBJECTIVE: To evaluate the effect of the Trendelenburg position on oxygen transport in hypovolemic patients. DESIGN: A prospective, self-controlled sequential design. INTERVENTIONS: All patients had indwelling pulmonary artery catheters, and hypovolemia was confirmed by a pulmonary artery wedge pressure of 6 mm Hg or less. Hemodynamic and oxygen transport variables were measured with the patient supine and again ten minutes after placing the patient in the Trendelenburg position. SETTING: University-affiliated tertiary care surgical ICU. TYPE OF PARTICIPANTS: Eight postoperative adults. RESULTS: Mean arterial blood pressure increased from 64.9 +/- 4.9 to 75.6 +/- 3.5 mm Hg (P < .05), pulmonary artery wedge pressure increased from 4.6 +/- 1.1 to 7.9 +/- 0.8 mm Hg (P < .05), and the systemic vascular resistance rose to 2,965 +/- 210 from 2,302 +/- 199 dyne.sec/cm5 (P < .05). There was no significant change in cardiac index, oxygen delivery, oxygen consumption, or oxygen extraction ratio. CONCLUSION: The increase in blood pressure from Trendelenburg position is not associated with an improvement in blood flow or tissue oxygenation.
STUDY OBJECTIVE: To evaluate the effect of the Trendelenburg position on oxygen transport in hypovolemicpatients. DESIGN: A prospective, self-controlled sequential design. INTERVENTIONS: All patients had indwelling pulmonary artery catheters, and hypovolemia was confirmed by a pulmonary artery wedge pressure of 6 mm Hg or less. Hemodynamic and oxygen transport variables were measured with the patient supine and again ten minutes after placing the patient in the Trendelenburg position. SETTING: University-affiliated tertiary care surgical ICU. TYPE OF PARTICIPANTS: Eight postoperative adults. RESULTS: Mean arterial blood pressure increased from 64.9 +/- 4.9 to 75.6 +/- 3.5 mm Hg (P < .05), pulmonary artery wedge pressure increased from 4.6 +/- 1.1 to 7.9 +/- 0.8 mm Hg (P < .05), and the systemic vascular resistance rose to 2,965 +/- 210 from 2,302 +/- 199 dyne.sec/cm5 (P < .05). There was no significant change in cardiac index, oxygen delivery, oxygen consumption, or oxygen extraction ratio. CONCLUSION: The increase in blood pressure from Trendelenburg position is not associated with an improvement in blood flow or tissue oxygenation.
Authors: Abraham Sonny; Daniel I Sessler; Jing You; Babak Kateby Kashy; Sheryar Sarwar; Akhil K Singh; Shiva Sale; Andrej Alfirevic; Andra E Duncan Journal: J Anesth Date: 2017-07-13 Impact factor: 2.078