Prediction of Fluid Responsiveness Using Dynamic Preload Indices During Arthroscopic Shoulder Surgery in the Beach Chair Position

Yonsei University42 enrolled

Overview

The beach chair position (BCP) has been commonly used for shoulder arthroscopic surgery. Hemodynamic instability is frequently encountered problem associated with BCP. In addition, high rates of cerebral desaturation events have been reported during surgery in BCP. Although fluid loading could alleviate hypotension associated with BCP, it may lead to volume overload. As an alternative to static indices, dynamic preload indices such as pulse pressure variation (PPV) and stroke volume variation (SVV) were reported to be sensitive predictors of fluid responsivness in several surgical condition. The investigators will examine the abilities of PPV and SVV to predict fluid responsivness during shoulder arthroscopic surgery in BCP. Using transesophageal echocardiography (TEE), the investigators will directly estimate the change of cardiac output during BCP.

Study Type

OBSERVATIONAL

Enrollment

Conditions

Shoulder Arthroscopy

Eligibility

Sex: ALLMin age: 20 YearsMax age: 75 Years

Medical Language ↔ Plain English

Inclusion Criteria: 1. Above 20 years of age. 2. American Society of Anesthesiologists (ASA) Physical Status I, II, III. 3. shoulder arthroscopy under Beach-chair position Exclusion Criteria: 1. severe functional liver or kidney disease 2. diagnosed HF ( NYHA class \>3) 3. cerebrovascular disease 4. Pregnancy

Outcomes

Primary Outcomes

The changes between dynamic preload indices (SVV and PPV) and stroke volume index during beach chair position. We will measure them to evaluate the effect of beach chair position on PPV and SVV.