British journal of anaesthesia
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Comparative Study
Delta down compared with delta pulse pressure as an indicator of volaemia during intracranial surgery.
Delta pulse pressure (DPP) and delta down (DD) are indicators of volaemia. The threshold value of DPP for discriminating between responders and non-responders to fluid loading (FL) is 13%. This study aimed at comparing DD with DPP during intracranial surgery. ⋯ DD is as efficient as DPP to assess hypovolaemia and predict responsiveness to FL in patients undergoing intracranial surgery. A 5 mm Hg DD value can be considered as a valuable threshold for initiating FL. These results support its use during intracranial surgery.
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Prone positioning of patients during anaesthesia is required to provide operative access for a wide variety of surgical procedures. It is associated with predictable changes in physiology but also with a number of complications, and safe use of the prone position requires an understanding of both issues. ⋯ The complications associated with this position and the published techniques for various practical procedures in this position will be discussed. The aim of this review is to identify the risks associated with prone positioning and how these risks may be anticipated and minimized.