Background and aims This consensus statement presents a comprehensive and evidence-based set of guidelines that modify the general European or US guidelines for hypotension management with vasopressors during cesarean delivery. It is tailored to the Southeast Asian context in terms of local human and medical resources, health system capacity, and local values and preferences. Methods and results These guidelines were prepared using a methodological approach. Two principal sources were used to obtain the evidence: scientific evidence and opinion-based evidence. A team of five anesthesia experts from Vietnam, the Philippines, and Thailand came together to define relevant clinical questions; search for literature-based evidence using the MEDLINE, Scopus, Google Scholar, and Cochrane libraries; evaluate existing guidelines; and contextualize recommendations for the Southeast Asian region. Furthermore, a survey was developed and distributed among 183 practitioners in the captioned countries to gather representative opinions of the medical community and identify best practices for the management of hypotension with vasopressors during cesarean section under spinal anesthesia. Conclusions This consensus statement advocates proactive management of maternal hypotension during cesarean section after spinal anesthesia, which can be detrimental for both the mother and fetus, supports the choice of phenylephrine as a first-line vasopressor and offers a perspective on the use of prefilled syringes in the Southeast Asian region, where factors such as healthcare features, availability, patient safety, and cost should be considered.
Vietnam is the land of all original and absorbed goddesses in Southeast Asia. Local goddesses such as Lieu Hanh,
CBT rooted some decades ago in the West and has currently been on the rapid rise thanks to the promotion of internet-based informatics. CBT tourists has shaped several driving forces and motivation to speed up the promotion and completion of CBT worldwide. Along with the boom of high-tech and its incredible pressures on human mind, post-modernism (PM) has been shaped due to the strong demand of liberalizing in human beings' mind and diversifying their lifestyles under the mutual interaction between ecological and cultural resources. PM starts firstly in arts and literature, gradually influences on business and tourism; hence impacts on CBT. The reconciliation of CBT and PM gives birth to discerning CBT advanced by discerning travelers who definitly care on their selfparticipation, self-experience, self-discovery during their journeys as well as the request for cooperation, co-controlling and co-responsibility of all the tourists, state agents and the local communities during the services. The discerning CBT travelers partially promote the commeners' awareness and engagement in advancing standard of life and civilizing of their lifestyle. Discerning CBT is surely not to replace popular CBT as a whole but to modify the diversity of modern tourism as it meets a concrete part of the various demands of tourists and pay more important role in standardizing human life.
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