Observational studyBMC anesthesiology2025
Predicting early postoperative hypotension after lung resection: a multiparameter model integrating non-invasive hemodynamic profiling and inferior vena cava collapsibility index (observational study).
Observational study in BMC anesthesiology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo analyze the influencing factors of postoperative hypotension (POH) following video-assisted thoracoscopic lung resection (VATS) and evaluate a predictive model combining non-invasive hemodynamic parameters with the inferior vena cava collapsibility index (IVCCI).
methodsA prospective study enrolled 100 VATS patients (September 2024-March 2025). Patients were stratified into POH (n = 36) and Non-POH (n = 64) groups based on mean arterial pressure (MAP ≤ 65 mmHg or ≥ 30% reduction from baseline) within 24 hours postoperatively. Hemodynamic parameters (cardiac output [CO], systemic vascular resistance [SVR], stroke volume [SV], stroke volume variation [SVV], left ventricular stroke work [LVSW]) were monitored using the Non-invasive Continuous Arterial Blood Pressure And Cardiac Output Monitoring System. IVCCI was ultrasonographically measured post-extubation. Linear regression analyzed correlations between post-anesthetic emergence period hemodynamic parameters and POH, while multivariable logistic regression analysis was employed to identify predictive factors, leading to the development and validation of a clinical prediction model.
resultsThe incidence of early POH was 36%. Multivariate analysis demonstrated that a model combining post-anesthesia emergence period left ventricular stroke work (PA_LVSW, OR = 0.880, P < 0.01), IVCCI (OR = 1.095, P = 0.01), baseline MAP, and ASA achieved an AUC of 0.940 (95% CI: 0.895-0.985), with 83.3% sensitivity and 89.1% specificity, outperforming individual predictors (IVCCI: AUC = 0.65; PA_LVSW༚AUC = 0.84).
conclusionEarly POH after VATS is closely associated with cardiac function suppression and volume status imbalance. The multiparameter model integrating PA_LVSW, IVCCI, ASA physical status, and baseline MAP effectively predicts POH.
trial registrationChinese Clinical Trial Register, ChiCTR2500100275. Registered 7 April 2025 Retrospectively registered, https//www.chictr.org.cn/showprojEN.html? proj=259,898.
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