Evaluation of integrated pulmonary index in patients with cardiac diseases undergoing ophthalmic surgery

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Objective. To evaluate integrated pulmonary index (IPI) and its prognostic value in anesthesia with sevoflurane and propofol in patients with cardiac comorbidities undergoing ophthalmic surgery. Material and methods. A prospective study included 40 patients with concomitant cardiac diseases undergoing elective ophthalmic surgery. Induction of anesthesia and insertion of a laryngeal mask was followed by randomization of patients into groups of inhalation anesthesia with sevoflurane (n=20) and intravenous anesthesia with propofol (n=20). Hemodynamic and respiratory parameters including IPI were assessed upon admission to the operating theatre, after induction of anesthesia and then every 30 minutes. Cognitive function was assessed before surgery and 24 hours later using the Montreal cognitive assessment scale. Results. We observed a decrease of IPI in the propofol group in 30 min after surgery onset (p=0.009). After induction of anesthesia and during the operation, administration of propofol was followed by increased SpO2 and reduced EtCO2 as compared to the sevoflurane group (p<0.05). By the end of surgery, we observed an increase of mean blood pressure in the propofol group (p<0.05), in the recovery unit — reduced heart rate and cardiac index (p<0.05). IPI <8 measured after induction of anesthesia was associated with postoperative cognitive dysfunction with area under curve of 0.77, sensitivity of 100% and specificity of 70% (p=0.04). Conclusion. Inhalation anesthesia with sevoflurane in patients with cardiac diseases undergoing ophthalmic surgery attenuates intraoperative hyperoxia, hypocapnia and hypertension and ensures increase of IPI. The use of sevoflurane prevents postoperative bradycardia and decrease of cardiac index. IPI after anesthesia induction correlates with cognitive function after intervention.

Keywords:

integrated pulmonary index

ophthalmic surgery

cardiac index

monitoring

Authors:

Yudina A.S.

Northern State Medical University;
Arkhangelsk Clinical Ophthalmological Hospital, Arkhangelsk, Russian Federation

Fot E.V.

Northern State Medical University, 163000, Arkhangelsk, Russia;
E.E. Volosevich City Clinical Hospital №1, 163000, Arkhangelsk, Russia

Kirov M.Yu.

FSBEI HE NSMU MOH Russia

SPIN RSCI: 2025-8162
Scopus AuthorID: 7004841942
ORCID: 0000-0002-4375-3374

List of references:

Zabolotskih IB, Grigor’ev SV, Karahalis NB, Muronov AE, Musaeva TS, Myasnikova VV, Sin’kov SV, Trembach NV. Perioperacionnoe vedenie pacientov s soputstvuyushchimi zabolevaniyami. Rukovodstvo dlya vrachej. V 3 t. Pod red. Zabolotskih I.B. T. 3. M.: Prakticheskaya medicina; 2018. (In Russ.).
Myasnikova VV, Bersenyov SV, Rylov PM, Komlev VA. Vedenie pacientov pozhilogo vozrasta v oftal’mohirurgii. M.: Prakticheskaya medicina; 2018. (In Russ.).
Vincent JL, Rhodes A, Perel A, Martin G, Rocca G, Vallet B, Pinsky MR, Hofer CK, Teboul JL, de Boode WP, Scolletta S, Vieillard-Baron A, De Backer D, Walley KR, Maggiorini M, Singer M. Clinical review: Update on hemodynamic monitoring — a consensus of 16. Critical Care. 2011;15(4):229. https://doi.org/10.1186/cc10291
Anesteziya i perioperacionnoe vedenie v oftal’mohirurgii. Pod red. Chuhraeva A.M., Sahnova S.N., Myasnikovoj V.V. M.: Prakticheskaya medicina; 2018. (In Russ.).
Osnovy intensivnoj terapii. Rukovodstvo WFSA. Pod red. Nedashkovskogo E.V., Kuz’kova V.V. Arhangel’sk: Pravda Severa: 2016. (In Russ.).
Dawes TR, Cheek E, Bewick V, Dennis M, Duckitt RW, Walker J, Forni LG, Venn R. Introduction of an electronic physiological early warning system: effects on mortality and length of stay. British Journal of Anaesthesia. 2014;113(4):603-609. https://doi.org/10.1093/bja/aeu107
Kyriacos U, Jelsma J, James M, Jordan S. Early warning scoring systems versus standard observations charts for wards in South Africa: a cluster randomized controlled trial. Trials. 2015;16:103-118. https://doi.org/10.1186/s13063-015-0624-2
Berkenstadt H, Ben-Menachem E, Herman A, Dach R. An evaluation of the Integrated Pulmonary Index (IPI) for the detection of respiratory events in sedated patients undergoing colonoscopy. Journal of Clinical Monitoring and Computing. 2012;26(3):177-181. https://doi.org/10.1007/s10877-012-9357-x
Heinze H, Sedemund-Adib B, Heringlake M, Meier T, Eichler W. Relationship between functional residual capacity, respiratory compliance, and oxygenation in patients ventilated after cardiac surgery. Respiratory Care. 2010;55:589-594.
Isserles SA, Breen PH. Can changes in end-tidal PCO2 measure changes in cardiac output? Anesthesia and Analgesia. 1991;73(6):808-814. https://doi.org/10.1213/00000539-199112000-00023
Dunham CM, Chirichella TJ, Gruber BS, Ferrari JP, Martin JA, Luchs BA, Hileman BM, Merrell R. In emergently ventilated trauma patients, low end-tidal CO2 and low cardiac output are associated and correlate with hemodynamic instability, hemorrhage, abnormal pupils, and death. BMC Anesthesiology. 2013;13(1):20-28. https://doi.org/10.1186/1471-2253-13-20
Pianisi P, Hochman J. End-tidal estimates of arterial PCO2 for cardiac output measurement by CO2 rebreathing: a study in patients with cystic fibrosis and healthy controls. Pediatric Pulmonology. 1996;22(3):154-160.
Izotova NN, Il’ina YaYu, Fot EV, Smetkin AA, Kuz’kov VV, Kirov MYu. Ultrasound-based monitoring of cardiac output after off-pump coronary artery bypass grafting. Vestnik intensivnoj terapii im. A.I. Saltanova. 2018;2:56-59. (In Russ.). https://doi.org/10.21320/1818-474x-2018-2-57-60
Perouansky M, Pearce R, Hemmings HJ. Chapter 25. Inhaled anesthetics: mechanisms of action. In: Miller RDCN, Eriksson LI, Fleisher LA, Wiener-Kronish JP, Young WL, eds. Anesthesia. 8th ed. New York: Churchill Livingstone Elsevier; 2014.
Ronen M, Weissbrod R, Overdyk FJ, Ajizian S. Smart respiratory monitoring: clinical development and validation of the IPITM (Integrated Pulmonary Index). Journal of Clinical Monitoring and Computing. 2017;31(2):435-442. https://doi.org/10.1007/s10877-016-9851-7
Garah J, Adiv OE, Rosen I, Shaoul R. The value of Integrated Pulmonary Index (IPI) monitoring during endoscopies in children. Journal of Clinical Monitoring and Computing. 2015;29(6):773-778. https://doi.org/10.1007/s10877-015-9665-z
Fot EV, Izotova NN, Yudina AS, Smyotkin AA, Kuz’kov VV, Kirov MYu. The value of the integrated pulmonary index in assessing the severity of the postoperative period in off-pump coronary artery bypass grafting. Vestnik anesteziologii i reanimatologii. 2016;2:21-28. (In Russ.).
Fot EV, Izotova NN, Yudina AS, Smetkin AA, Kuzkov VV, Kirov MY. The predictive value of integrated pulmonary index after off-pump coronary artery bypass grafting: a prospective observational study. Frontiers in Medicine. 2017;4:132. https://doi.org/10.3389/fmed.2017.00132
Fot EV, Gajdukov KM, Neverova MS, Smetkin AA, Kuzkov VV, Kirov MY. Dynamics of the integrated pulmonary index after coronary artery bypass grafting on the background of respiratory support and spontaneous breathing. Vestnik anesteziologii i reanimatologii. 2011;5:17-22. (In Russ.).
Guo JY, Fang JY, Xu SR, Wei M. Effects of propofol versus sevoflurane on cerebral oxygenation and cognitive outcome in patients with impaired cerebral oxygenation. Therapeutics and Clinical Risk Management. 2016;12:81-85. https://doi.org/10.2147/tcrm.s97066
Obrazczov MYu, Ivashhenko OYu, Ivashhenko NYu, Anisimov MG, Goren`kov VM, Kuz`kov VV, Kirov MYu. Effects of different types of anesthesia on cerebral oxygenation and cognitive functions in carotid endartectomy. Vestnik anesteziologii i reanimatologii. 2017;1:3-13. (In Russ.). https://doi.org/10.21292/2078-5658-2017-14-1-3-13

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