Document Detail


Use of an automated anesthesia information system to determine reference limits for vital signs during cesarean section.
MedLine Citation:
PMID:  10385858     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
INTRODUCTION: We evaluated whether automated anesthesia information systems can be used to calculate reference limits (population-based "normal values") for vital signs. We considered four populations of women undergoing cesarean section: healthy under spinal anesthesia, healthy under general anesthesia, pre-eclamptic/eclamptic under spinal anesthesia, and pre-eclamptic/eclamptic under general anesthesia. METHODS: Reference limits were calculated for each of the study populations by determination of percentiles for: minimum heart rate, maximum heart rate, minimum arterial oxyhemoglobin saturation (SaO2), minimum mean arterial pressure (MAP), maximum MAP, decrease in MAP, and increase in MAP. RESULTS: There was one adverse anesthetic outcome among the 1,300 women in the study; the woman sustained a post-dural puncture headache. The 5th percentiles of SaO2 were at least 95% saturation under spinal versus 90% under general. Under spinal anesthesia, 95th percentiles for decreases in MAP from baseline were 63 mmHg for healthy and 75 mmHg for pre-eclamptic/eclamptic women. Under general anesthesia, the 95th percentiles for maximum MAP were 161 and 177 mmHg, respectively. Two women of the 1,300 patients experienced simultaneously a minimum SaO2 < 92% and minimum MAP < 50 mmHg. DISCUSSION: Automated anesthesia information systems can be used to determine reference limits for vital signs during anesthesia. Reference limits may play a role in malpractice cases when an expert claims that care by an anesthesiologist was sub-standard as shown by vital signs that were not maintained within the normal range during the critical portions of an anesthetic. Automated anesthesia information systems may enhance expert witnesses' clinical judgment.
Authors:
F Dexter; D H Penning; D A Lubarsky; E DeLong; I Sanderson; B C Gilbert; E Bell; J G Reves
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Publication Detail:
Type:  Journal Article; Research Support, Non-U.S. Gov't    
Journal Detail:
Title:  Journal of clinical monitoring and computing     Volume:  14     ISSN:  1387-1307     ISO Abbreviation:  J Clin Monit Comput     Publication Date:  1998 Dec 
Date Detail:
Created Date:  1999-08-17     Completed Date:  1999-08-17     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  9806357     Medline TA:  J Clin Monit Comput     Country:  NETHERLANDS    
Other Details:
Languages:  eng     Pagination:  491-8     Citation Subset:  IM    
Affiliation:
Department of Anesthesiology, Duke University, USA. franklin-dexter@uiowa.edu
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MeSH Terms
Descriptor/Qualifier:
Adult
Anesthesia, General* / adverse effects,  methods
Anesthesia, Spinal* / adverse effects,  methods
Cesarean Section*
Eclampsia
Female
Humans
Information Systems*
Malpractice*
Monitoring, Physiologic / standards*
Pre-Eclampsia
Pregnancy
Reference Values

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


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