International Ophthalmology

, Volume 39, Issue 9, pp 1949–1954 | Cite as

Integrated Pulmonary Index (IPI) monitorization under sedation in cataract surgery with phacoemulsification technique

  • Arzu Yıldırım ArEmail author
  • Süheyla Abitağaoğlu
  • Güldem Turan
  • Ceren Şanlı Karip
  • Nur Akgün
  • Doğa Meriç Boybeyi
  • Dilek Erdoğan Arı
Original Paper



We aimed to investigate that change of IPI values after sedation of patients undergoing cataract surgery under sedation.


We included 50 patients (ASA I–III) undergoing cataract surgery under sedation by phacoemulsification method in this prospective observational study. IPI, SpO2, ETCO2, respiratory rate (RR), peripheral pulse rate (PR), hemodynamic data and BIS values and perioperative complications were recorded.


Compared to baseline values, RR value at 5th min, RR, PR, IPI values at 10th min and RR, PR values at 15th min were significantly low and heart rate value at 15th min and arterial pressure, bispectral index (BIS) values at 5th min, 10th min, 15th min, 20th min, 25th min and 30th min were lower than baseline values.


IPI monitoring will provide guidance during sedation of patients with comorbid diseases undergoing cataract surgery by phacoemulsification method.


Sedation Hypoxemia Hypoventilation Monitoring Phacoemulsification 


Compliance with ethical standards

Conflict of interest

Arzu Yıldırım Ar, Süheyla Abitağaoğlu, Güldem Turan, Ceren Şanlı Karip, Nur Akgün, Doğa Meriç Boybeyi and Dilek Erdoğan Arı declare that they have no conflict of interest.


  1. 1.
    Nouvellon E, Cuvillon P, Ripart J, Viel EJ (2010) Anaesthesia for cataract surgery. Drugs Aging 27(1):21–38CrossRefGoogle Scholar
  2. 2.
    Katz J, Feldman MA, Bass EB, Lubomski LH, Tielsch JM, Petty BG, Fleisher LA, Schein OD (2001) Adverse intraoperative medical events and their association with anesthesia management strategies in cataract surgery. Ophthalmology 108:1721–1726CrossRefGoogle Scholar
  3. 3.
    Murty C (2009) Sedation guidelines for gastro intestinal endoscopy. Med J Armed Forces India 65:161–165CrossRefGoogle Scholar
  4. 4.
    Ronen M, Weissbrod R, Overdyk FJ, Ajizian S (2017) Smart respiratory monitoring: clinical development and validation of the IPI (Integrated Pulmonary Index) algorithm. J Clin Monit Comput 31(2):435–442CrossRefGoogle Scholar
  5. 5.
    Mermer D, Turan G, Koksal C, Ayanoglu Tas B, Karadogan F, Akgun N (2016) Correlation of integrated pulmonary index with clinical observation in unilateral and bilateral spinal anaesthesia in geriatric patients. Int J Res 4(10):4438–4443Google Scholar
  6. 6.
    Turan G, Kuplay Y, Karip C, Koksal C, Akın C, Akgun N (2016) Integrated Pulmonary Index: a new strategy for respiratory patients evaluation. Int J Anesthetic Anesthesiol 3:042CrossRefGoogle Scholar
  7. 7.
    Berkenstadt H, Menachem EB, Herman A, Dach R (2012) An evaluation of the Integrated Pulmonary Index (IPI) for the detection of respiratory events in sedated patients undergoing colonoscopy. J Clin Monit Comput 26:177–181CrossRefGoogle Scholar
  8. 8.
    Kaur R, Vines DL, Liu L, Balk RA (2017) Role of Integrated Pulmonary Index in identifying extubation failure. Respir Care. Google Scholar
  9. 9.
    Sabbatani P, Mantovan R (2013) Electrical cardioversion of atrial fibrillation: evaluation of sedation safety with midazolam by means of EtCO2 and IPI algorithm analysis. Int J Cardiol 169:430–432CrossRefGoogle Scholar
  10. 10.
    Vaessen HHB, Knape JTA (2016) An evaluation of the Integrated Pulmonary Index (IPI) fort he detection of respiratory events in propofol sedated patients undergoing upper gastrointestinal endoscopy. J Hepatol Gastroint Dis 2:2Google Scholar
  11. 11.
    Garah J, Adiv OE, Rosen I, Shaoul R (2015) The value of Integrated Pulmonary Index (IPI) monitoring during endoscopies in children. J Clin Monit Comput 29:773–778CrossRefGoogle Scholar
  12. 12.
    Wang D, Wang S, Chen J, Xu Y, Chen C, Long A, Zhu Z, Lıu J, Deng D, Chen J, Tang D, Wang L (2013) Propofol combined with traditional sedative agents versus propofol-alone sedation for gastrointestinal endoscopy: a meta analysis. Scand J Gastroenterol 48:101–110CrossRefGoogle Scholar
  13. 13.
    Vargo JJ, Zuccaro G, Dumot JA, Conwell DL, Morrow JB, Shay SS (2002) Automated graphic assessment of respiratory activity is superior to pulse oximetry and visual assessment for the detection of early respiratory depression during therapeutic upper endoscopy. Gastrointest Endosc 55:826–831CrossRefGoogle Scholar
  14. 14.
    Riphaus A, Wehrman T, Kronshage T, Geist C, Pox CP, Heringlake S, Schmiegel W, Beitz A, Meining A, Müller M, Delius S (2017) Clinical value of the Integrated Pulmonary Index during sedation for interventional upper GI-endoscopy: a randomized prospective tri-center study. Dig Liver Dis 49:45–49CrossRefGoogle Scholar
  15. 15.
    Fot EV, Izotova NN, Yudina AS, Smetkin AA, Kuzkov VV, Kirov MY (2017) The predictive value of Integrated Pulmonary Index after off-pump coronary artery grafting: a prospective observational study. Front Med 4:132. CrossRefGoogle Scholar

Copyright information

© Springer Nature B.V. 2018

Authors and Affiliations

  1. 1.Anesthesiology and Reanimation DepartmentFatih Sultan Mehmet Educational and Research HospitalIstanbulTurkey

Personalised recommendations