Non-Invasive Hemodynamic Assessment of Non-pregnant, Healthy Pregnant and Preeclamptic Women using Bio-Reactance

Ohashi, Yayoi; Ibrahim, Hisham; Furtado, Louis; Kingdom, John; Carvalho, José Carlos Almeida

doi:10.1016/s0034-7094(10)70075-1

Cited by 29 publications

(16 citation statements)

References 25 publications

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“…Several studies have indicated that the LL position is the best position for a pregnant woman on a traditional stretcher 5,8,9,15,16,17. However, prior to this study, there were no references in the medical literature to the PP on stretchers specifically designed for pregnant women.…”

Section: Discussionmentioning

confidence: 97%

Influence of the prone position on a stretcher for pregnant women on maternal and fetal hemodynamic parameters and comfort in pregnancy

Oliveira¹,

Lopes²,

Rodrigues³

et al. 2017

Clinics

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OBJECTIVES:To analyze the influence of lying in prone position on a specially designed stretcher on the maternal-fetal hemodynamic parameters and comfort of pregnant women.METHODS:A randomized, controlled trial with 33 pregnant women divided into 2 groups: pregnant group sequence 1 and pregnant group sequence 2. The order of positions used in sequence 1 was Fowler’s position, prone position, supine position, left lateral, Fowler’s position 2, supine position 2, prone position 2 and left lateral 2. The order of positions used in sequence 2 was Fowler’s position, prone position, left lateral, supine position, Fowler’s position 2, left lateral 2, prone position 2 and supine position 2. Each woman remained in each position for 6 minutes. For the statistical analyses, we used Wilcoxon’s test for 2 paired samples when comparing the prone position with the other positions. The variables are presented in graphs showing the means and 95% confidence intervals. Trial Registration: Clinical Trial No. ISRCTN41359519RESULTS:All the parameters were within the standards of normality. There were no differences between positions in terms of maternal heart rate, diastolic blood pressure, oxygen saturation and fetal heart rate. However, there were significant decreases in respiratory rate and systolic blood pressure in prone position 2 compared with left lateral 2. There was an increase in oxygen saturation in prone position compared with Fowler’s position and supine position 2 in both sequences. All the women reported feeling comfortable in the prone position.CONCLUSIONS:The prone position was considered safe and comfortable and could be advantageous for improving oxygen saturation and reducing the systolic blood pressure and respiratory rate.

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Section: Discussionmentioning

confidence: 97%

Influence of the prone position on a stretcher for pregnant women on maternal and fetal hemodynamic parameters and comfort in pregnancy

Oliveira¹,

Lopes²,

Rodrigues³

et al. 2017

Clinics

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“…Its accuracy has been tested against that of thermodilution in both animals and humans, 15 and it has been used in pregnant patients. [16][17][18] The NICOM has been found to have acceptable accuracy, and it correlates well with more established methods of CO monitoring. 14 Little has been studied regarding the use of NICOM in patients with grossly abnormal cardiovascular anatomy; however, the underlying physics of bioreactance technology is based on thoracic pulsatility, which takes into account the entire volume of blood in the thoracic cage irrespective of which side it occurs in the cardiac anatomy.…”

Section: Discussionmentioning

confidence: 73%

Cardiac output monitoring during Cesarean delivery in a patient with palliated tetralogy of Fallot

Clivatti

Smith

Sermer

et al. 2012

Can J Anesth/J Can Anesth

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Purpose Tetralogy of Fallot (TOF) is one of the most common causes of cyanotic congenital heart disease. The anesthetic management of parturients with uncorrected TOF is challenging and controversial, especially for Cesarean delivery (CD). We describe the use of noninvasive cardiac output (CO) monitoring to assist the management of CD for a woman with palliated TOF under general anesthesia. Clinical features A 34-yr-old woman presented for elective CD at 38 weeks gestation. Having been born with TOF, she underwent a modified Blalock-Taussig shunt at six years of age, followed nine years later by creation of an aortopulmonary connection. The patient's functional status was New York Heart Association class I despite evident central cyanosis. A CD was performed under general anesthesia. Fentanyl, etomidate, and succinylcholine were utilized for induction, and intrathecal morphine was administered for postoperative pain control. The baseline CO (7.2 LÁmin -1 ), blood pressure (156/74 mmHg), heart rate (74 beatsÁmin -1 ), and total peripheral resistance (1,059 dynesÁsec -1 Ácm -5 ) remained stable throughout the procedure. Maintenance anesthesia consisted of rocuronium, sevoflurane, and an oxygen/nitrous oxide mixture. Upon delivery, an infusion of oxytocin combined with ergometrine was administered. Hemodynamic parameters remained stable and no vasopressor was required. Conclusion Balanced general anesthesia and careful titration of uterotonic agents provided stable hemodynamic conditions during CD in a patient with a palliated TOF, as assessed by a continuous noninvasive CO monitor. Noninvasive CO monitoring may improve our understanding of the hemodynamic implications of various anesthetic techniques for CD in cardiac patients. RésuméObjectif La te´tralogie de Fallot (TF) est l'une des causes les plus fre´quentes de cardiopathie conge´nitale cyanosante. La prise en charge anesthe´sique des parturientes ayant une TF non corrige´e est controverse´e et rele`ve du de´fi, en particulier en cas d'accouchement par ce´sarienne. Nous de´crivons l'utilisation d'un monitorage non invasif du de´bit cardiaque (DC) pour aider la prise en charge de la ce´sarienne chez une femme ayant une TF ope´re´e sous anesthe´sie ge´ne´rale. Caractéristiques cliniques Une femme aˆge´e de 34 ans se pre´sente pour une ce´sarienne programme´e à 38 semaines de grossesse. Elle est ne´e avec une TF et a subi une intervention modifie´e de Blalock-Taussig a`l'aˆge de six ans, puis neuf ans plus tard la cre´ation d'une connexion aorto-pulmonaire. Le statut fonctionnel de la patiente

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“…This has also been noted previously, disproving the usual assumption that low systemic vascular resistance persists throughout pregnancy to term 13 . In fact, our group has recently demonstrated with the same technology that healthy pregnant women at term have a very similar hemodynamic profile when compared to non-pregnant women 14 . This should have significant implications for teaching and understanding clinical practice in the near future.…”

Section: Discussionmentioning

confidence: 92%

“…Bioreactance technology is a newer form of non-invasive continuous cardiac output monitoring 10,14 , and has recently been used in the obstetric population for the first time 14 . It is based on an analysis of the relative phase shifts of oscillating currents that occur when the current traverses the thoracic cavity, as opposed to the traditional bioimpedance-based system which relies only on measured changes in signal amplitude.…”

Section: Discussionmentioning

confidence: 99%

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

Doherty

Ohashi

Downey

et al. 2011

Rev. Bras. Anestesiol.

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Background and objectives:Blood pressure monitoring offers a limited understanding of the hemodynamic consequences of spinal anesthesia for cesarean delivery. The purpose of this study was to assess, with the aid of a non-invasive cardiac output monitor based on bioreactance, the hemodynamic changes during elective cesarean delivery under spinal anesthesia in which intermittent boluses of phenylephrine were used to prevent and treat hypotension.

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Non-Invasive Hemodynamic Assessment of Non-pregnant, Healthy Pregnant and Preeclamptic Women using Bio-Reactance

Abstract: The NICOM device is simple to use, operator independent, and provides clear and consistent monitoring signals. The output identified distinct hemodymamic profiles that are consistent with the findings of more invasive existing methods.

Cited by 29 publications

References 25 publications

Influence of the prone position on a stretcher for pregnant women on maternal and fetal hemodynamic parameters and comfort in pregnancy

Influence of the prone position on a stretcher for pregnant women on maternal and fetal hemodynamic parameters and comfort in pregnancy

Cardiac output monitoring during Cesarean delivery in a patient with palliated tetralogy of Fallot

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

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