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ORIGINAL ARTICLE   Free accessfree

Minerva Anestesiologica 2018 November;84(11):1279-86

DOI: 10.23736/S0375-9393.18.12461-8


lingua: Inglese

The presence of elastic compression stockings reduces the fluid responsiveness of patients in the operating room

Elie ZOGHEIB 1, 2 , Julien MAIZEL 2, 3, Nabil CHERRADI 1, 4, Ammar BENAMMAR 1, Béatrice LABONT 1, Abdel HCHIKAT 1, Michael BERNASINSKI 1, Faouzi TROJETTE 1, Michel SLAMA 2, 3, Hervé DUPONT 1, 2

1 Department of Anesthesiology and Critical Care Medicine, Amiens University Hospital, Amiens, France; 2 INSERM U 1088, Jules Verne University of Picardy, Amiens, France; 3 Unit of Medical Intensive Care, Amiens University Hospital, Amiens, France; 4 Department of Anesthesiology and Critical Care Medicine, Montgarde Hospital CHPM, Aubergenville, France

BACKGROUND: The aim of this study was to investigate whether elastic compression stockings (ECS) can affect fluid responsiveness parameters before and during passive leg raising (PLR) maneuvers.
METHODS: In the operating room (OR), we performed a prospective study including patients referred for cardiac surgery. Blood pressure (BP), ΔPP, heart rate (HR), central venous pressure (CVP), stroke volume (SV) and aortic blood flow (ABF) (by esophageal doppler) were measured according to four conditions: supine position without ECS (baseline 1), lower limbs raised to an angle of 45° (PLR 1), returned to the supine position with ECS (baseline 2), then a second PLR maneuver with ECS was performed (PLR 2).
RESULTS: Twenty patients were included. BP, SV, ABF and CVP increased significantly. ΔPP and HR decreased during PLR 1. At baseline 2, HR and ΔPP decreased significantly compared to baseline 1. During PLR 2, increase of SV (4% [9]) and ABF (4% [9]), and the decrease of ΔPP (-19% [104]) were significantly lower than those observed at PLR 1 (7% [21] P=0.05; 9% [8] P=0.02 and -66% [40] P=0.02, respectively). Eleven patients presented a ΔPP≥13% at baseline 1. Only 1 patient still presented a ΔPP≥13% with ECS at baseline 2. Only 3/9 patients with an increase of ABF ≥10% and 2/11 patients with an increase of PP ≥12% during the PLR 1 presented similar results during PLR 2.
CONCLUSIONS: In the OR, ECS provoke a self-fluid loading increasing ABF, decreasing ΔPP and PLR response. The presence of ECS should be considered when managing hemodynamic parameters of patients.

KEY WORDS: Stockings, compression - Operating rooms - Thoracic surgery

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