Hemodynamics, fluids & transfusion
Fluid responsiveness and hypotension in patients undergoing propofol-based sedation for colonoscopy following bowel preparation: a prospective cohort study
Authors' conclusion
Patients undergoing elective colonoscopy after bowel preparation were often fluid responsive. These patients were more likely to have significant intraprocedural hypotension than patients who were volume replete. Transthoracic echocardiography assessment of volume status cannot be readily replaced by ClearSight monitoring.
Study context
- Population
- Adults undergoing elective colonoscopy following bowel preparation with propofol-based sedation, Royal Melbourne Hospitalcompleted the study
- Participants
- 99 adults
- Exposure
- Fluid-responsive vs normovolemic patients; TTE vs ClearSight
- Fluid-responsiven = 29
- Outcome
- Intravascular volume depletion (positive passive leg raise test on TTE: 15% increase in subaortic velocity time integral)
- Follow-up
- Preprocedure
Main finding
As reported in the abstract
Positive passive leg raise test on TTE, 29 of 90 patients with adequate TTE images
32%
95% CI 23 to 43
Observational data: associations, not effects.
Further findings
Agreement of TTE and ClearSight stroke volume · Baseline and after passive leg raising
- Inadequate agreement between average TTE and ClearSight measurements of stroke volume
Safety
Significant intraprocedural hypotension (MAP < 60 mm Hg)
Original publication
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