Monitoramento não invasivo baseado na biorreatância revela instabilidade hemodinâmica significativa durante cesárea eletiva sob raquianestesia

Doherty, Anne Marie; Ohashi, Yayoi; Downey, Kristi; Carvalho, Jose C. A.

doi:10.1590/s0034-70942011000300007

Cited by 2 publications

(3 citation statements)

References 23 publications

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“…However, the effects of variations in body size and physical factors on electrical conduction have limited the clinical use of bioimpedance (21). Nevertheless, the accuracy and predictive value of the bioreactance-based NICOM™ device has been demonstrated during elective cesarean delivery under spinal anesthesia (9).…”

Section: Discussionmentioning

confidence: 99%

“…However, none of these methods has been widely adopted in clinical practice due to variability in the accuracy of results (3)(4)(5)(6)(7)(8). The recently developed bioreactance-based non-invasive cardiac output monitoring (NICOM™) system (Cheetah Medical; Baxter International Inc.) provides an accurate monitoring method for parturients under spinal anesthesia (9). Unlike bioimpedance, bioreactance is accompanied by fewer adverse effects associated with body movement (9,10).…”

Section: Introductionmentioning

confidence: 99%

“…The recently developed bioreactance-based non-invasive cardiac output monitoring (NICOM™) system (Cheetah Medical; Baxter International Inc.) provides an accurate monitoring method for parturients under spinal anesthesia (9). Unlike bioimpedance, bioreactance is accompanied by fewer adverse effects associated with body movement (9,10). However, frequent position alterations during induction of spinal anesthesia have been commonly observed.…”

Section: Introductionmentioning

confidence: 99%

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Observation of hemodynamic parameters using a non-invasive cardiac output monitor system to identify predictive indicators for post-spinal anesthesia hypotension in parturients undergoing cesarean section

2020

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The administration of high-level spinal anesthesia for cesarean section may lead to significant hemodynamic changes. Bioreactance-based non-invasive cardiac output monitoring (NICOM™) provides an accurate monitoring system for parturients under spinal anesthesia. The present study hypothesized that baseline hemodynamic parameters obtained via the NICOM™ system could serve as predictive indicators for post-spinal anesthesia hypotension. Therefore, 80 full-term parturients with singleton pregnancies who underwent scheduled cesarean section were enrolled and allocated to either a supine position group or a 15˚ left tilt group. All parturients received standard pre-hydration with 750 ml of 0.9% saline. Baseline cardiac output index (CI), total peripheral resistance index (TPRI) and stroke volume (SV) were recorded using the NICOM™ system. Subsequently, spinal anesthesia with 2.4 ml of 0.5% hyperbaric bupivacaine, 10 µg of fentanyl and 0.2 mg of morphine was administered. Receiver operating characteristic (ROC) curves and multivariate logistic regression were used to analyze the data. A total of 40 parturients (51.9%) developed hypotension. The areas under the ROC curves were 0.666, 0.594 and 0.622 for the CI, TPRI and SV, respectively. The optimal cutoff value of the CI in predicting hypotension was 3.68 l/min/m 2 (ROC, sensitivity=85.0%, specificity=48.6%). Furthermore, CI was considered as an independent factor for post-spinal anesthesia hypotension. In conclusion, the baseline CI obtained via the bioreactance-based NICOM™ system may serve as a predictor of post-spinal anesthesia hypotension in parturients regardless of patient position.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Observation of hemodynamic parameters using a non-invasive cardiac output monitor system to identify predictive indicators for post-spinal anesthesia hypotension in parturients undergoing cesarean section

2020

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Phenylephrine Infusion Versus Bolus Regimens During Cesarean Delivery Under Spinal Anesthesia

Doherty

Ohashi

Downey

et al. 2012

Anesthesia &Amp; Analgesia

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There were no clinical benefits to administering phenylephrine as an infusion versus a bolus regimen. The bolus regimen maintained maternal arterial blood pressure closer to baseline in the initial minutes after spinal injection but this had no clinical benefits. The infusion regimen required a higher total dose of phenylephrine to maintain maternal arterial blood pressure at baseline during the predelivery period.

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Monitoramento não invasivo baseado na biorreatância revela instabilidade hemodinâmica significativa durante cesárea eletiva sob raquianestesia

Cited by 2 publications

References 23 publications

Observation of hemodynamic parameters using a non-invasive cardiac output monitor system to identify predictive indicators for post-spinal anesthesia hypotension in parturients undergoing cesarean section

Observation of hemodynamic parameters using a non-invasive cardiac output monitor system to identify predictive indicators for post-spinal anesthesia hypotension in parturients undergoing cesarean section

Phenylephrine Infusion Versus Bolus Regimens During Cesarean Delivery Under Spinal Anesthesia

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