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Impact of maternal lateral tilt on cardiac output during caesarean section under spinal anaesthesia: a prospective observational study
BACKGROUND: Left uterine displacement (LUD) has been questioned as an effective strategy to prevent aortocaval compression after spinal anesthesia (SA) for cesarean delivery (CD). We tested if LUD has a significant impact on cardiac output (CO) in patients undergoing CD under SA during continuous no...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8996426/ https://www.ncbi.nlm.nih.gov/pubmed/35410115 http://dx.doi.org/10.1186/s12871-022-01640-6 |
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author | Sonnino, Chiara Frassanito, Luciano Piersanti, Alessandra Giuri, Pietro Paolo Zanfini, Bruno Antonio Catarci, Stefano Draisci, Gaetano |
author_facet | Sonnino, Chiara Frassanito, Luciano Piersanti, Alessandra Giuri, Pietro Paolo Zanfini, Bruno Antonio Catarci, Stefano Draisci, Gaetano |
author_sort | Sonnino, Chiara |
collection | PubMed |
description | BACKGROUND: Left uterine displacement (LUD) has been questioned as an effective strategy to prevent aortocaval compression after spinal anesthesia (SA) for cesarean delivery (CD). We tested if LUD has a significant impact on cardiac output (CO) in patients undergoing CD under SA during continuous non-invasive hemodynamic monitoring with Clearsight. METHODS: Forty-six patients were included in the final analysis. We considered 4 timepoints of 5 min each: T1 = baseline with LUD; T2 = baseline without LUD; T3 = after SA with LUD; T4 = after SA without LUD. LUD was then repositioned for CD. The primary outcome was to assess if CO decreased from T3 to T4 of at least 1.0 L/min. We also compared CO between T1 and T2 and other hemodynamic variables: mean, systolic and diastolic blood pressure (respectively MAP, SAP and DAP), heart rate (HR), stroke volume (SV), stroke volume variation (SVV), pulse pressure variation (PPV), contractility (dP/dt), dynamic arterial elastance (Ea(dyn)) at the different timepoints. Data on fetal Apgar scores and umbilical arterial and venous pH were collected. RESULTS: CO did not vary from T3 to T4 (CO mean difference -0.02 L/min [95% CI -0.88 to 0.82; P = 1). No significant variation was registered for any variable at any timepoint. CONCLUSIONS: LUD did not show a significant impact on CO during continuous hemodynamic monitoring after SA for CD. TRIAL REGISTRATION: (retrospectively registered on 03/12/2021) NCT05143684. |
format | Online Article Text |
id | pubmed-8996426 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-89964262022-04-12 Impact of maternal lateral tilt on cardiac output during caesarean section under spinal anaesthesia: a prospective observational study Sonnino, Chiara Frassanito, Luciano Piersanti, Alessandra Giuri, Pietro Paolo Zanfini, Bruno Antonio Catarci, Stefano Draisci, Gaetano BMC Anesthesiol Research BACKGROUND: Left uterine displacement (LUD) has been questioned as an effective strategy to prevent aortocaval compression after spinal anesthesia (SA) for cesarean delivery (CD). We tested if LUD has a significant impact on cardiac output (CO) in patients undergoing CD under SA during continuous non-invasive hemodynamic monitoring with Clearsight. METHODS: Forty-six patients were included in the final analysis. We considered 4 timepoints of 5 min each: T1 = baseline with LUD; T2 = baseline without LUD; T3 = after SA with LUD; T4 = after SA without LUD. LUD was then repositioned for CD. The primary outcome was to assess if CO decreased from T3 to T4 of at least 1.0 L/min. We also compared CO between T1 and T2 and other hemodynamic variables: mean, systolic and diastolic blood pressure (respectively MAP, SAP and DAP), heart rate (HR), stroke volume (SV), stroke volume variation (SVV), pulse pressure variation (PPV), contractility (dP/dt), dynamic arterial elastance (Ea(dyn)) at the different timepoints. Data on fetal Apgar scores and umbilical arterial and venous pH were collected. RESULTS: CO did not vary from T3 to T4 (CO mean difference -0.02 L/min [95% CI -0.88 to 0.82; P = 1). No significant variation was registered for any variable at any timepoint. CONCLUSIONS: LUD did not show a significant impact on CO during continuous hemodynamic monitoring after SA for CD. TRIAL REGISTRATION: (retrospectively registered on 03/12/2021) NCT05143684. BioMed Central 2022-04-11 /pmc/articles/PMC8996426/ /pubmed/35410115 http://dx.doi.org/10.1186/s12871-022-01640-6 Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Sonnino, Chiara Frassanito, Luciano Piersanti, Alessandra Giuri, Pietro Paolo Zanfini, Bruno Antonio Catarci, Stefano Draisci, Gaetano Impact of maternal lateral tilt on cardiac output during caesarean section under spinal anaesthesia: a prospective observational study |
title | Impact of maternal lateral tilt on cardiac output during caesarean section under spinal anaesthesia: a prospective observational study |
title_full | Impact of maternal lateral tilt on cardiac output during caesarean section under spinal anaesthesia: a prospective observational study |
title_fullStr | Impact of maternal lateral tilt on cardiac output during caesarean section under spinal anaesthesia: a prospective observational study |
title_full_unstemmed | Impact of maternal lateral tilt on cardiac output during caesarean section under spinal anaesthesia: a prospective observational study |
title_short | Impact of maternal lateral tilt on cardiac output during caesarean section under spinal anaesthesia: a prospective observational study |
title_sort | impact of maternal lateral tilt on cardiac output during caesarean section under spinal anaesthesia: a prospective observational study |
topic | Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8996426/ https://www.ncbi.nlm.nih.gov/pubmed/35410115 http://dx.doi.org/10.1186/s12871-022-01640-6 |
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