A beat-by-beat, on-line, cardiovascular index, CARDEAN, to assess circulatory responses to surgery: a randomized clinical trial during spine surgery
Automated assessment of circulatory response to surgical stimuli is unsolved. Would detection of cardiac baroreflex inhibition assess adequacy of intra-operative anti-nociception upon incision, as performed on-line on a beat-by-beat basis by a cardiovascular index, CARDEAN™? 18 ASA I-II patients und...
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| Veröffentlicht in: | Journal of clinical monitoring and computing 2012-12, Vol.26 (6), p.441-449 |
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| creator | Rossi, M. Cividjian, A. Fevre, M. C. Oddoux, M. E. Carcey, J. Halle, C. Frost, M. Gardellin, M. Payen, J. F. Quintin, L. |
| description | Automated assessment of circulatory response to surgical stimuli is unsolved. Would detection of cardiac baroreflex inhibition assess adequacy of intra-operative anti-nociception upon incision, as performed on-line on a beat-by-beat basis by a cardiovascular index, CARDEAN™? 18 ASA I-II patients undergoing spinal disc repair were studied, in a prospective randomized single-blinded trial (observational study). During infusion of propofol to maintain bispectral index between 40 and 60, patients were allocated to receive an effect site target-controlled infusion of remifentanil at Ce = 2 or 4 ng ml
−1
. Upon incision and during surgery, circulatory response was assessed using beat-by-beat measurements of minor hypertension and tachycardia to give a cardiovascular index, CARDEAN, scaled between 0 and 100. Upon skin incision, CARDEAN increased in the remifentanil Ce = 2 ng ml
−1
group (n = 7,
P
60 was associated with tachycardia and hypertension (
P
k
= 0.81 ± 0.10). Changes in CARDEAN appeared linked to adequacy of anti-nociception. |
| doi_str_mv | 10.1007/s10877-012-9372-y |
| format | Article |
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−1
. Upon incision and during surgery, circulatory response was assessed using beat-by-beat measurements of minor hypertension and tachycardia to give a cardiovascular index, CARDEAN, scaled between 0 and 100. Upon skin incision, CARDEAN increased in the remifentanil Ce = 2 ng ml
−1
group (n = 7,
P
< 0.05), while it did not increase in the remifentanil Ce = 4 ng ml
−1
group (n = 7,
P
= 0.18). During surgery, retrospectively, CARDEAN > 60 was associated with tachycardia and hypertension (
P
k
= 0.81 ± 0.10). Changes in CARDEAN appeared linked to adequacy of anti-nociception.</description><identifier>ISSN: 1387-1307</identifier><identifier>EISSN: 1573-2614</identifier><identifier>DOI: 10.1007/s10877-012-9372-y</identifier><identifier>PMID: 22684738</identifier><identifier>CODEN: JCMCFG</identifier><language>eng</language><publisher>Dordrecht: Springer Netherlands</publisher><subject>Adequacy ; Adult ; Analgesics, Opioid ; Anesthesiology ; Anesthetics, Intravenous ; Baroreflex ; Blood Pressure ; Circulation ; Critical Care Medicine ; Female ; Health Sciences ; Heart Rate ; Hemodynamics ; Humans ; Hypertension ; Infusion ; Intensive ; Intervertebral Disc - surgery ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Monitoring, Intraoperative ; Nociception ; On-line systems ; Patients ; Piperidines ; Propofol ; Single-Blind Method ; Statistics for Life Sciences ; Surgery ; Tachycardia ; Tachycardia - diagnosis</subject><ispartof>Journal of clinical monitoring and computing, 2012-12, Vol.26 (6), p.441-449</ispartof><rights>Springer Science+Business Media, LLC 2012</rights><rights>Springer Science+Business Media New York 2012</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c405t-66f084f8075e934d26376a096aab74c329d02ca75ab67ca9845c8a787e4139ce3</citedby><cites>FETCH-LOGICAL-c405t-66f084f8075e934d26376a096aab74c329d02ca75ab67ca9845c8a787e4139ce3</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://link.springer.com/content/pdf/10.1007/s10877-012-9372-y$$EPDF$$P50$$Gspringer$$H</linktopdf><linktohtml>$$Uhttps://link.springer.com/10.1007/s10877-012-9372-y$$EHTML$$P50$$Gspringer$$H</linktohtml><link.rule.ids>314,776,780,27901,27902,41464,42533,51294</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/22684738$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Rossi, M.</creatorcontrib><creatorcontrib>Cividjian, A.</creatorcontrib><creatorcontrib>Fevre, M. C.</creatorcontrib><creatorcontrib>Oddoux, M. E.</creatorcontrib><creatorcontrib>Carcey, J.</creatorcontrib><creatorcontrib>Halle, C.</creatorcontrib><creatorcontrib>Frost, M.</creatorcontrib><creatorcontrib>Gardellin, M.</creatorcontrib><creatorcontrib>Payen, J. F.</creatorcontrib><creatorcontrib>Quintin, L.</creatorcontrib><title>A beat-by-beat, on-line, cardiovascular index, CARDEAN, to assess circulatory responses to surgery: a randomized clinical trial during spine surgery</title><title>Journal of clinical monitoring and computing</title><addtitle>J Clin Monit Comput</addtitle><addtitle>J Clin Monit Comput</addtitle><description>Automated assessment of circulatory response to surgical stimuli is unsolved. Would detection of cardiac baroreflex inhibition assess adequacy of intra-operative anti-nociception upon incision, as performed on-line on a beat-by-beat basis by a cardiovascular index, CARDEAN™? 18 ASA I-II patients undergoing spinal disc repair were studied, in a prospective randomized single-blinded trial (observational study). During infusion of propofol to maintain bispectral index between 40 and 60, patients were allocated to receive an effect site target-controlled infusion of remifentanil at Ce = 2 or 4 ng ml
−1
. Upon incision and during surgery, circulatory response was assessed using beat-by-beat measurements of minor hypertension and tachycardia to give a cardiovascular index, CARDEAN, scaled between 0 and 100. Upon skin incision, CARDEAN increased in the remifentanil Ce = 2 ng ml
−1
group (n = 7,
P
< 0.05), while it did not increase in the remifentanil Ce = 4 ng ml
−1
group (n = 7,
P
= 0.18). During surgery, retrospectively, CARDEAN > 60 was associated with tachycardia and hypertension (
P
k
= 0.81 ± 0.10). Changes in CARDEAN appeared linked to adequacy of anti-nociception.</description><subject>Adequacy</subject><subject>Adult</subject><subject>Analgesics, Opioid</subject><subject>Anesthesiology</subject><subject>Anesthetics, Intravenous</subject><subject>Baroreflex</subject><subject>Blood Pressure</subject><subject>Circulation</subject><subject>Critical Care Medicine</subject><subject>Female</subject><subject>Health Sciences</subject><subject>Heart Rate</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypertension</subject><subject>Infusion</subject><subject>Intensive</subject><subject>Intervertebral Disc - surgery</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Monitoring, Intraoperative</subject><subject>Nociception</subject><subject>On-line systems</subject><subject>Patients</subject><subject>Piperidines</subject><subject>Propofol</subject><subject>Single-Blind Method</subject><subject>Statistics for Life Sciences</subject><subject>Surgery</subject><subject>Tachycardia</subject><subject>Tachycardia - diagnosis</subject><issn>1387-1307</issn><issn>1573-2614</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2012</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNqFkcuKFDEUhoMozkUfwI0E3LjoaG6Vk7hr2vECg4LoOqRS6SFDdaVMqgbL5_CBJ0XPiAjiJiecfP9_OPkResboK0YpvC6MagBCGSdGACfLA3TKGhCEKyYf1rvQQJigcILOSrmmlBot2GN0wrnSEoQ-Rb-2uA1uIu1C1rrBaSB9HMIGe5e7mG5c8XPvMo5DF35s8G775e3F9tMGTwm7UkIp2Me8IlPKC86hjGmo7fW9zPkq5OUNdji7oUuH-DN02Ff76F2Ppxzr2c05Dle4jHXoveIJerR3fQlP7-o5-vbu4uvuA7n8_P7jbntJvKTNRJTaUy33mkITjJAdVwKUo0Y514L0gpuOcu-gca0C74yWjdcONATJhPFBnKOXR98xp-9zKJM9xOJD37shpLlYxrUARplh_0dZw4BSxZqKvvgLvU5zHuoilZJGg5RgKsWOlM-plBz2dszx4PJiGbVruvaYrq3p2jVdu1TN8zvnuT2E7rfiPs4K8CNQxvVXQ_5j9D9dbwG847AB</recordid><startdate>20121201</startdate><enddate>20121201</enddate><creator>Rossi, M.</creator><creator>Cividjian, A.</creator><creator>Fevre, M. C.</creator><creator>Oddoux, M. E.</creator><creator>Carcey, J.</creator><creator>Halle, C.</creator><creator>Frost, M.</creator><creator>Gardellin, M.</creator><creator>Payen, J. 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C. ; Oddoux, M. E. ; Carcey, J. ; Halle, C. ; Frost, M. ; Gardellin, M. ; Payen, J. F. ; Quintin, L.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c405t-66f084f8075e934d26376a096aab74c329d02ca75ab67ca9845c8a787e4139ce3</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2012</creationdate><topic>Adequacy</topic><topic>Adult</topic><topic>Analgesics, Opioid</topic><topic>Anesthesiology</topic><topic>Anesthetics, Intravenous</topic><topic>Baroreflex</topic><topic>Blood Pressure</topic><topic>Circulation</topic><topic>Critical Care Medicine</topic><topic>Female</topic><topic>Health Sciences</topic><topic>Heart Rate</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Hypertension</topic><topic>Infusion</topic><topic>Intensive</topic><topic>Intervertebral Disc - surgery</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Monitoring, Intraoperative</topic><topic>Nociception</topic><topic>On-line systems</topic><topic>Patients</topic><topic>Piperidines</topic><topic>Propofol</topic><topic>Single-Blind Method</topic><topic>Statistics for Life Sciences</topic><topic>Surgery</topic><topic>Tachycardia</topic><topic>Tachycardia - diagnosis</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Rossi, M.</creatorcontrib><creatorcontrib>Cividjian, A.</creatorcontrib><creatorcontrib>Fevre, M. 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C.</au><au>Oddoux, M. E.</au><au>Carcey, J.</au><au>Halle, C.</au><au>Frost, M.</au><au>Gardellin, M.</au><au>Payen, J. F.</au><au>Quintin, L.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>A beat-by-beat, on-line, cardiovascular index, CARDEAN, to assess circulatory responses to surgery: a randomized clinical trial during spine surgery</atitle><jtitle>Journal of clinical monitoring and computing</jtitle><stitle>J Clin Monit Comput</stitle><addtitle>J Clin Monit Comput</addtitle><date>2012-12-01</date><risdate>2012</risdate><volume>26</volume><issue>6</issue><spage>441</spage><epage>449</epage><pages>441-449</pages><issn>1387-1307</issn><eissn>1573-2614</eissn><coden>JCMCFG</coden><abstract>Automated assessment of circulatory response to surgical stimuli is unsolved. Would detection of cardiac baroreflex inhibition assess adequacy of intra-operative anti-nociception upon incision, as performed on-line on a beat-by-beat basis by a cardiovascular index, CARDEAN™? 18 ASA I-II patients undergoing spinal disc repair were studied, in a prospective randomized single-blinded trial (observational study). During infusion of propofol to maintain bispectral index between 40 and 60, patients were allocated to receive an effect site target-controlled infusion of remifentanil at Ce = 2 or 4 ng ml
−1
. Upon incision and during surgery, circulatory response was assessed using beat-by-beat measurements of minor hypertension and tachycardia to give a cardiovascular index, CARDEAN, scaled between 0 and 100. Upon skin incision, CARDEAN increased in the remifentanil Ce = 2 ng ml
−1
group (n = 7,
P
< 0.05), while it did not increase in the remifentanil Ce = 4 ng ml
−1
group (n = 7,
P
= 0.18). During surgery, retrospectively, CARDEAN > 60 was associated with tachycardia and hypertension (
P
k
= 0.81 ± 0.10). Changes in CARDEAN appeared linked to adequacy of anti-nociception.</abstract><cop>Dordrecht</cop><pub>Springer Netherlands</pub><pmid>22684738</pmid><doi>10.1007/s10877-012-9372-y</doi><tpages>9</tpages></addata></record> |
| fulltext | fulltext |
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| ispartof | Journal of clinical monitoring and computing, 2012-12, Vol.26 (6), p.441-449 |
| issn | 1387-1307 1573-2614 |
| language | eng |
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| source | MEDLINE; SpringerLink Journals |
| subjects | Adequacy Adult Analgesics, Opioid Anesthesiology Anesthetics, Intravenous Baroreflex Blood Pressure Circulation Critical Care Medicine Female Health Sciences Heart Rate Hemodynamics Humans Hypertension Infusion Intensive Intervertebral Disc - surgery Male Medicine Medicine & Public Health Middle Aged Monitoring, Intraoperative Nociception On-line systems Patients Piperidines Propofol Single-Blind Method Statistics for Life Sciences Surgery Tachycardia Tachycardia - diagnosis |
| title | A beat-by-beat, on-line, cardiovascular index, CARDEAN, to assess circulatory responses to surgery: a randomized clinical trial during spine surgery |
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