Abstract：
BACKGROUND: The primary aim of this proof-of-concept study was to investigate whether the Cardiac Power Index (CPI) could be a novel alternative method to assess fluid responsiveness in the prone position.
METHODS: Patients undergoing scheduled elective lumbar spine surgery in the prone position under general anesthesia were enrolled in the criteria of patients aged 19-75 years with American Society of Anesthesiologists (ASA) physical status I-II. The hemodynamic variables were evaluated before and after changes in posture after administering a colloid bolus (5 mL.kg-1) in the prone position. Fluid responsiveness was defined as an increase in the Stroke Volume Index (SVI) ≥ 10%.
RESULTS: A total of 28 patients were enrolled. In responders, the CPI (median [1/4Q-3/4Q]) decreased to 0.34 [0.28-0.39] W.m-2 (p = 0.035) after the prone position. After following fluid loading, CPI increased to 0.48 [0.37-0.52] W.m-2 (p < 0.008), and decreased SVI (median [1/4Q-3/4Q]) after prone increased from 26.0 [24.5-28.0] mL.m-2 to 33.0 [31.0-37.5] mL.m-2 (p = 0.014). Among non-responders, CPI decreased to 0.43 [0.28-0.53] W.m-2 (p = 0.011), and SVI decreased to 29.0 [23.5-34.8] mL.m-2 (p < 0.009). CPI exhibited predictive capabilities for fluid responsiveness as a receiver operating characteristic curve of 0.78 [95% Confidence Interval, 0.60-0.95; p = 0.025].
CONCLUSIONS: This study suggests the potential of CPI as an alternative method to existing preload indices in assessing fluid responsiveness in clinical scenarios, offering potential benefits for responders and non-responders.
METHODS: Patients undergoing scheduled elective lumbar spine surgery in the prone position under general anesthesia were enrolled in the criteria of patients aged 19-75 years with American Society of Anesthesiologists (ASA) physical status I-II. The hemodynamic variables were evaluated before and after changes in posture after administering a colloid bolus (5 mL.kg-1) in the prone position. Fluid responsiveness was defined as an increase in the Stroke Volume Index (SVI) ≥ 10%.
RESULTS: A total of 28 patients were enrolled. In responders, the CPI (median [1/4Q-3/4Q]) decreased to 0.34 [0.28-0.39] W.m-2 (p = 0.035) after the prone position. After following fluid loading, CPI increased to 0.48 [0.37-0.52] W.m-2 (p < 0.008), and decreased SVI (median [1/4Q-3/4Q]) after prone increased from 26.0 [24.5-28.0] mL.m-2 to 33.0 [31.0-37.5] mL.m-2 (p = 0.014). Among non-responders, CPI decreased to 0.43 [0.28-0.53] W.m-2 (p = 0.011), and SVI decreased to 29.0 [23.5-34.8] mL.m-2 (p < 0.009). CPI exhibited predictive capabilities for fluid responsiveness as a receiver operating characteristic curve of 0.78 [95% Confidence Interval, 0.60-0.95; p = 0.025].
CONCLUSIONS: This study suggests the potential of CPI as an alternative method to existing preload indices in assessing fluid responsiveness in clinical scenarios, offering potential benefits for responders and non-responders.
摘要：
背景：这项概念验证研究的主要目的是研究心脏功率指数（CPI）是否可以作为评估俯卧位液体反应性的新方法。
方法：将在全身麻醉下进行俯卧位择期腰椎手术的患者纳入19-75岁患者的标准，这些患者的身体状态为I-II。在施用胶体推注（5mL。kg-1)在俯卧位。流体反应性定义为每搏输出量指数(SVI)增加≥10%。
结果：共纳入28例患者。在响应者中，俯卧位后，CPI（中位数[1/4Q-3/4Q]）降至0.34[0.28-0.39]W.m-2（p=0.035）。流体加载后，CPI升至0.48[0.37-0.52]W.m-2(p<0.008)，俯卧位从26.0[24.5-28.0]mL增加后，SVI降低（中位数[1/4Q-3/4Q]）。m-2至33.0[31.0-37.5]mL。m-2(p=0.014)。在非响应者中，CPI降至0.43[0.28-0.53]W.m-2（p=0.011），SVI降至29.0[23.5-34.8]mL。m-2(p<0.009)。作为0.78[95%置信区间的接收器工作特征曲线，CPI表现出流体响应性的预测能力，0.60-0.95；p=0.025]。
结论：这项研究表明，在评估临床情景中，CPI作为现有预负荷指数的替代方法的潜力，为响应者和非响应者提供潜在的好处。
方法：将在全身麻醉下进行俯卧位择期腰椎手术的患者纳入19-75岁患者的标准，这些患者的身体状态为I-II。在施用胶体推注（5mL。kg-1)在俯卧位。流体反应性定义为每搏输出量指数(SVI)增加≥10%。
结果：共纳入28例患者。在响应者中，俯卧位后，CPI（中位数[1/4Q-3/4Q]）降至0.34[0.28-0.39]W.m-2（p=0.035）。流体加载后，CPI升至0.48[0.37-0.52]W.m-2(p<0.008)，俯卧位从26.0[24.5-28.0]mL增加后，SVI降低（中位数[1/4Q-3/4Q]）。m-2至33.0[31.0-37.5]mL。m-2(p=0.014)。在非响应者中，CPI降至0.43[0.28-0.53]W.m-2（p=0.011），SVI降至29.0[23.5-34.8]mL。m-2(p<0.009)。作为0.78[95%置信区间的接收器工作特征曲线，CPI表现出流体响应性的预测能力，0.60-0.95；p=0.025]。
结论：这项研究表明，在评估临床情景中，CPI作为现有预负荷指数的替代方法的潜力，为响应者和非响应者提供潜在的好处。
