Document Detail


Clinical evaluation of the flotrac/Vigileo system for continuous cardiac output monitoring in patients undergoing regional anesthesia for elective cesarean section: a pilot study.
MedLine Citation:
PMID:  20835557     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Spinal anesthesia for cesarean delivery may cause severe maternal hypotension and a decrease in cardiac output. Compared to assessment of cardiac output via a pulmonary artery catheter, the FloTrac/Vigileo system may offer a less invasive technique. The aim of this study was to evaluate cardiac output and other hemodynamic measurements made using the FloTrac/Vigileo system in patients undergoing spinal anesthesia for elective cesarean section.
METHODS: A prospective study enrolling 10 healthy pregnant women was performed. Hemodynamic parameters were continuously obtained at 15 main points: admission to surgery (two baseline measurements), after preload, after spinal anesthesia administration and 4 time points thereafter (4, 6, 8 and 10 min after anesthesia), at skin and uterine incision, newborn and placental delivery, oxytocin administration, end of surgery, and recovery from anesthesia. Hemodynamic therapy was guided by mean arterial pressure, and vasopressors were used as appropriate to maintain baseline values. A repeated measures ANOVA was used for data analysis.
RESULTS: There was a significant increase in heart rate and a decrease of stroke volume and stroke volume index up to 10 min after spinal anesthesia (P < 0.01). Importantly, stroke volume variation increased immediately after newborn delivery (P < 0.001) and returned to basal values at the end of surgery. Further hemodynamic parameters showed no significant changes over time.
DISCUSSION AND CONCLUSIONS: No significant hemodynamic effects, except for heart rate and stroke volume changes, were observed in pregnant women managed with preload and vasopressors when undergoing elective cesarean section and spinal anesthesia.
Authors:
José Otavio Costa Auler; Marcelo L A Torres; Mônica M Cardoso; Thais C Tebaldi; André P Schmidt; Mario M Kondo; Marcelo Zugaib
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Clinics (São Paulo, Brazil)     Volume:  65     ISSN:  1980-5322     ISO Abbreviation:  Clinics (Sao Paulo)     Publication Date:  2010 Jun 
Date Detail:
Created Date:  2010-09-13     Completed Date:  2011-11-03     Revised Date:  2013-05-29    
Medline Journal Info:
Nlm Unique ID:  101244734     Medline TA:  Clinics (Sao Paulo)     Country:  Brazil    
Other Details:
Languages:  eng     Pagination:  793-8     Citation Subset:  IM    
Affiliation:
Department of Anesthesia and Critical Care, Heart Institute, Hospital das Clínicas, Universidade de Sao Paulo, Sao Paulo, Brazil, SP. auler@hcnet.usp.br
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Anesthesia, Conduction*
Anesthesia, Spinal*
Blood Pressure / physiology
Cardiac Output / physiology*
Cesarean Section*
Female
Hemodynamics / physiology
Humans
Monitoring, Physiologic / instrumentation
Pilot Projects
Pregnancy
Prospective Studies
Stroke Volume / physiology
Young Adult
Comments/Corrections

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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