Intraoperative physiological ranges associated with improved outcomes after major spine surgery: an observational study

ObjectiveThere is inadequate information about the values of many intraoperative physiological measurements that are associated with improved outcomes after surgery. The purpose of this observational study is to investigate the optimal physiological ranges during major spine surgery.SettingA teachin...

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Bibliographic Details
Published in:BMJ open 2019-05, Vol.9 (5), p.e025337-e025337
Main Authors: Li, Gang, Lin, Liang, Xiao, Jifang, Rosenbaum, Stanley, Bickler, Philip, Meng, Lingzhong
Format: Article
Language:English
Subjects:
Aged
Anaesthesia
Anesthesia
Anesthesiology
Area Under Curve
Blood pressure
Clinical outcomes
Cohort Studies
Female
Heart surgery
Hemodynamics - physiology
Hospitals, Teaching
Humans
Intensive care
Male
Middle Aged
Monitoring, Intraoperative
Observational studies
Oxygen Consumption - physiology
Patients
Physiology
Prone Position - physiology
Spinal Fusion
Systematic review
United States
Variables
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Summary:ObjectiveThere is inadequate information about the values of many intraoperative physiological measurements that are associated with improved outcomes after surgery. The purpose of this observational study is to investigate the optimal physiological ranges during major spine surgery.SettingA teaching hospital in the USA.ParticipantsA convenience sample of 102 patients receiving major posterior spine surgery with multilevel spinal fusion in a prone position.MethodsPhysiological variables, including but not limited to mean arterial pressure (MAP) and cerebral and somatic tissue oxygen saturation (SctO2/SstO2), were recorded. The results of these measurements were associated with length of hospital stay and composite complication data and were analysed based on thresholds (ie, a cut-off value for optimal and suboptimal physiology) and the area under the curve (AUC) values. The AUC values were measured as the area enclosed by the actual tracing and the threshold. The outcomes were dichotomised into above-average and below-average (ie, improved) categories.ResultsAnalyses based on thresholds identified the following variables associated with above-average outcomes: MAP
ISSN:2044-6055
2044-6055
DOI:10.1136/bmjopen-2018-025337