J Clin Monit Comput - Continuous measurement of cardiac output with the electrical velocimetry method in patients under spinal anesthesia for cesarean delivery.

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Resumo

In this study, we aimed to continuously measure cardiac output (CO) with the electrical velocimetry (EV) method and characterize the hemodynamic profile of patients undergoing spinal anesthesia for elective cesarean delivery (CD), and to discuss the potential benefit of using real time CO monitoring to guide patient management. Forty-two patients scheduled for elective CD under spinal anesthesia were enrolled in this observational study. A non-invasive CO monitor incorporating the electrical velocimetry algorithm, ICON(?) (Cardiotronic(?), La Jolla, California, USA), was used to measure CO and stroke volume (SV) continuously. Peripheral venous pressure was measured intermittently at pre-defined time points. Systemic vascular resistance was calculated retrospectively after completion of the study. Hemodynamic changes at pre-defined time points and caused by phenylephrine administration were analyzed. Hypotension (MAP reduction more than 20?% from baseline values) occurred in 71.1?% of patients after spinal anesthesia, while the coinstantaneous CO was increased =20?% from baseline in the majority of patients (76.3?%) at the same time. Significant increase in CO took place at 3-2?min before the administration of phenylephrine bolus. Treatment of hypotension with phenylephrine was associated with significant decrease in CO. Continuous CO monitoring with EV enables clinicians to determine CO and SV changes prior to onset of hypotension and to better understand patients' hemodynamics. It is an important addition to the current monitoring. The benefit of routinely using this technique remains to be determined in term of the patient outcomes.

Resumo Limpo

studi aim continu measur cardiac output co electr velocimetri ev method character hemodynam profil patient undergo spinal anesthesia elect cesarean deliveri cd discuss potenti benefit use real time co monitor guid patient manag fortytwo patient schedul elect cd spinal anesthesia enrol observ studi noninvas co monitor incorpor electr velocimetri algorithm icon cardiotron la jolla california usa use measur co stroke volum sv continu peripher venous pressur measur intermitt predefin time point system vascular resist calcul retrospect complet studi hemodynam chang predefin time point caus phenylephrin administr analyz hypotens map reduct baselin valu occur patient spinal anesthesia coinstantan co increas baselin major patient time signific increas co took place min administr phenylephrin bolus treatment hypotens phenylephrin associ signific decreas co continu co monitor ev enabl clinician determin co sv chang prior onset hypotens better understand patient hemodynam import addit current monitor benefit routin use techniqu remain determin term patient outcom

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