Changes in pleth variability index and detection of hypotension during spinal anaesthesia for caesarean section

Hypotension occurs commonly during caesarean section under spinal anaesthesia. As the onset may be rapid, it may fail to be detected by non-invasive blood pressure (BP) measurement in a timely fashion.1 Pulse oximeters can continuously and non-invasively measure tissue perfusion (perfusion index (PI)) and its variation with the respiratory cycle (pleth variability index (PVI)). As with stroke volume variation, PVI predicts fluid responsiveness in mechanically ventilated patients with a high degree of sensitivity and specificity.
Source: International Journal of Obstetric Anesthesia - Category: Anesthesiology Authors: Tags: Correspondence Source Type: research

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CONCLUSION Bolus human albumin 5% was not superior to bolus ringer acetate in maintaining systemic or mesenteric oxygen delivery in elective major upper gastrointestinal cancer surgery, despite the administration of larger volumes of trial fluid in the ringer acetate group. No significant difference was seen in fluid-related complications or LOS. TRIAL REGISTRATION https://eudract.ema.europa.eu/ Identifier: 2013-002217-36.
Source: European Journal of Anaesthesiology - Category: Anesthesiology Tags: Haemodynamics Source Type: research
ConclusionsWe found that prolonged SCP time and coronary artery disease increased the risk of postoperative stroke. Heterogeneous carotid plaque, history of cerebrovascular disease, concomitant CABG and prolonged operation time were further significant predictors of POCD.
Source: Journal of Anesthesia - Category: Anesthesiology Source Type: research
AbstractInconsistency in outcome parameters for delayed cerebral ischemia (DCI) makes it difficult to compare results between mouse studies, in the same way inconsistency in outcome parameters in human studies has for long obstructed adequate comparison. The absence of an established definition may in part be responsible for the failed translational results. The present article proposes a standardized definition for DCI in experimental mouse models, which can be used as outcome measure in future animal studies. We used a consensus-building approach to propose a definition for “experimental secondary ischemia” (...
Source: Translational Stroke Research - Category: Neurology Source Type: research
In this study, we intravenously administrated the young mitochondria into aged mice to evaluate whether energy production increase in aged tissues or age-related behaviors improved after the mitochondrial transplantation. The results showed that heterozygous mitochondrial DNA of both aged and young mouse coexisted in tissues of aged mice after mitochondrial administration, and meanwhile, ATP content in tissues increased while reactive oxygen species (ROS) level reduced. Besides, the mitotherapy significantly improved cognitive and motor performance of aged mice. Our study, at the first report in aged animals, not only prov...
Source: Fight Aging! - Category: Research Authors: Tags: Newsletters Source Type: blogs
Purpose of review This review summarizes the physiological basis of autoregulation-oriented therapy in critically ill patients, with a particular emphasis on individual targets based on parameters that describe autoregulation of cerebral blood flow. Recent findings The concepts of optimal cerebral perfusion (CPPopt) and arterial pressures (ABPopt), which both take advantage of continuous measures of cerebral autoregulation, recently have been introduced into clinical practice. It is hypothesized that if both pressures are used as individual targets and followed, the incidence and severity of dysautoregulation will dim...
Source: Current Opinion in Critical Care - Category: Nursing Tags: ACUTE NEUROLOGICAL PROBLEMS: Edited by Peter Le Roux Source Type: research
AbstractPurpose of reviewEndovascular thrombectomy (ET), the standard of treatment for emergent large vessel occlusion (ELVO) strokes, has been subject to rigorous efforts to further improve its usage and delivery for optimised patient outcomes. This review aims to provide an outline and discussion about the recently established and emerging recommendations regarding endovascular treatment of stroke.Recent findingsThe indications for ET have expanded continually, with perfusion imaging now enabling selection of patients presenting 6 –24 h after last-known-well, and improved device and operator proficiency allowi...
Source: Current Treatment Options in Cardiovascular Medicine - Category: Cardiology Source Type: research
AbstractPerioperative goal-directed hemodynamic therapy (GDHT) has evolved from invasive “supra-physiological” maximization of oxygen delivery to minimally or even noninvasively guided automated stroke volume optimization. Over the past four decades, investigators have simultaneously developed novel monitors, updated strategies, and automated technologies to improve GDHT. Decision s upport technology, which proposes an intervention based on the patient’s real time physiologic status, was an important step towards automation. Closed-loop systems have now been created to both increase GDHT compliance and de...
Source: Journal of Anesthesia - Category: Anesthesiology Source Type: research
Purpose of review Stroke is the second leading cause of death and the third leading cause of disability worldwide. Treatment is time limited and delays cost lives. This review discusses modern stroke management, during a time when treatments and guidelines are rapidly evolving. Recent findings Stroke thrombectomy has become the therapy of choice for large vessel occlusion (LVO) strokes. Perfusion imaging techniques, both computed tomography (CT) and MRI, now allow treatment beyond a set time window in specific patients. Both general anaesthesia and conscious sedation are options for patients undergoing stroke thrombec...
Source: Current Opinion in Anaesthesiology - Category: Anesthesiology Tags: NEUROANESTHESIA: Edited by Lingzhong Meng Source Type: research
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Source: Anesthesiology - Category: Anesthesiology Source Type: research
The search for safe and effective patient management strategies during weaning from cardiopulmonary bypass is ongoing; intravenous calcium is occasionally used as a first-line drug. The physiologic role of calcium suggests that it can support the function of the cardiovascular system during this critical period. Patients may be mildly hypocalcemic after cardiopulmonary bypass; however, this degree of hypocalcemia does not significantly impair the cardiovascular system. The transient beneficial effects of calcium administration (increase in arterial blood pressure, systemic vascular resistance, cardiac index, stroke volume,...
Source: Journal of Cardiothoracic and Vascular Anesthesia - Category: Anesthesiology Authors: Tags: Review Article Source Type: research
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