RESUMEN
INTRODUCTION: Prevalence and tobacco-related perioperative complications have been largely reported. The impact of vaping (e-cigarette use) on the perioperative period has been rarely evaluated. The purpose of this multicentre cross-sectional survey was to assess the prevalence of vaping and behaviour of patients undergoing elective surgery. METHODS: After institutional review board committee and patient approvals, patients (aged ≥18 years) scheduled for elective non-cardiac surgery in six French hospitals were assessed preoperatively. Demographic characteristics, and information on vaping, smoking or dual-use status and consumption were reported. RESULTS: In six centres, 1712 eligible patients were approached and 1664 patients were included in this study from June 2016 to January 2017. Of these, 62 patients used e-cigarettes in the preoperative period (3%; 95% CI: 2-4), including 24 exclusive e-cigarette users (1%; 95% CI: 1-2), 38 dual-users (2%; 95% CI: 2-3) and 365 smokers (22%; 95% CI: 20-24). Vapers were older than smokers (53 vs 47 years old; p=0.01). During the preoperative period, 12 patients (1%) reported vaping the morning of surgery. CONCLUSIONS: In the preoperative period, vaping was ten-fold less prevalent than smoking. Although the clinical relevance may be weak, further research is needed to explore the real impact of vaping on patients' outcomes and to elaborate on clinical recommendations.
RESUMEN
BACKGROUND AND OBJECTIVE: The present prospective study was aimed at assessing the reliability of the pulse contour method for measuring cardiac output (CO) after different routinely used therapeutic interventions that can influence vascular compliance and systemic vascular resistances in ICU patients (fluid challenges, changes in norepinephrine or dobutamine infusion rates and changes in ventilatory settings). METHODS: In ICU patients requiring CO monitoring, transpulmonary thermodilution CO (COTD) and pulse contour CO (COPC) were measured with a PiCCO device after therapeutic manoeuvre-free periods (≤ and >1 h) and after therapeutic interventions without recalibration. RESULTS: Three hundred fifty-two sets of CO measurement pairs in 63 ICU patients were performed. The biases (and percentage errors) between COPC and COTD for the overall paired measurement, therapeutic manoeuvre-free periods and therapeutic manoeuvres were 0.20 ± 1.09 (33%), -0.01 ± 0.93 (29%) and 0.37 ± 1.18 (34%), respectively. The percentage errors were 36 and 39% for fluid challenges and changes in norepinephrine infusion rate, respectively. CONCLUSION: In ICU patients requiring therapeutic interventions, COPC is frequently in disagreement with COTD.