Implications of Continuous Noninvasive Finger Cuff Arterial Pressure Device Use during Cesarean Delivery for Goal-Directed Fluid Therapy Preload Optimization: A Randomized Controlled Trial
Background. Although fixed-volume conventional fluid preloading protocol fails to attenuate postspinal hypotension during cesarean delivery, the effect of goal-directed fluid therapy (GDFT) remains less explored. Continuous noninvasive finger cuff arterial pressure monitoring using devices such as t...
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| description | Background. Although fixed-volume conventional fluid preloading protocol fails to attenuate postspinal hypotension during cesarean delivery, the effect of goal-directed fluid therapy (GDFT) remains less explored. Continuous noninvasive finger cuff arterial pressure monitoring using devices such as the ClearSight System can provide the noninvasive stroke volume value, enabling clinicians to perform GDFT before spinal anesthesia; however, the efficacy of GDFT requires further elucidation. Method. In total, 71 consecutive full-term pregnant women were randomly divided into a control group (n=34) and a GDFT group (n=37). Before spinal anesthesia, the control group received a fixed dose (1000 mL) of crystalloid fluid, but the GDFT group received repeated 3 mL/kg body weight of crystalloid fluid challenges within 3 minutes with a 1-minute interval between each fluid challenge based on the stroke volume incremental changes obtained using the ClearSight System (targeting a stroke volume increase of ≥5% after a fluid challenge). The primary outcome was the incidence of postspinal hypotension. The secondary outcomes were total fluid volume, vasopressor dosage, hemodynamic parameter changes, maternal adverse effects, and neonatal profiles. Result. Women in the GDFT group received more fluid than did those in the control group (1132±108 vs. 1247±202 mL; p=0.0044), but the incidence of postspinal hypotension (79.4% vs. 73.0%,; p=0.5864) and norepinephrine dose (12.5±10.6 vs. 15.1±12.8 mcg, respectively; p=0.3512) was comparable between the two groups. Fewer women in the GDFT group experienced nausea (61.76% vs. 35.14%; p=0.0332). Neonatal outcomes (Apgar score and umbilical blood analysis) were comparable and typical in both groups. Conclusion. ClearSight-guided GDFT did not ameliorate postspinal hypotension but may reduce nausea. This trial is registered with NCT03013140. |
| doi_str_mv | 10.1155/2021/6685584 |
| format | Article |
| fullrecord | <record><control><sourceid>gale_pubme</sourceid><recordid>TN_cdi_pubmedcentral_primary_oai_pubmedcentral_nih_gov_8019625</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><galeid>A696941941</galeid><sourcerecordid>A696941941</sourcerecordid><originalsourceid>FETCH-LOGICAL-c476t-b4b536f8bd6535d1a2a2b3d63f4f26e705844bc4fb4833f62d39e74b20649be13</originalsourceid><addsrcrecordid>eNp9kk1vEzEQhlcIRKvSG2dkiQsShPprvbsckKKUlEoVRSg9W971OHHl2Km9GxR-Gz8OLwnh44BlySPPM69fj6YonhP8lpCyvKCYkgsh6rKs-aPilDLCJ4Jw8vgYM3ZSnKd0j_OqicCNeFqcMJYrcI1Pi-_X642znept8AkFg2bB99YPYUjoU_DWb1WyW0Bz65cQ0WwwBk1jD9Eqhz5HSGmIgC5haztAdwmQHmJG0QySiqB8TrlcH3fIhIiugnKTSxuh60GjuRusRosVRLXZjWIuKI1uN71d228_Hb1DU_RFeR3yRS4YvcXgXA4Xo4FnxROjXILzw3lW3M0_LGYfJze3V9ez6c2k45XoJy1vSyZM3WpRslITRRVtmRbMcEMFVDg3j7cdNy2vGTOCatZAxVuKBW9aIOyseL_X3QztGnQH2YZychPtWsWdDMrKvzPeruQybGWNSSNomQVeHQRieBgg9XJtUwfOKQ-505KWhFHOK1Zl9OU_6H0Yos_fyxSuqSgpqX9TS-VAWm9CfrcbReVUNKLhJO9MvdlTXQwpRTBHywTLcX7kOD_yMD8Zf_HnN4_wr2nJwOs9sLJeq6_2_3I_ADj6z1c</addsrcrecordid><sourcetype>Open Access Repository</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2508265218</pqid></control><display><type>article</type><title>Implications of Continuous Noninvasive Finger Cuff Arterial Pressure Device Use during Cesarean Delivery for Goal-Directed Fluid Therapy Preload Optimization: A Randomized Controlled Trial</title><source>MEDLINE</source><source>Wiley Online Library Open Access</source><source>PubMed Central</source><source>Alma/SFX Local Collection</source><source>PubMed Central Open Access</source><creator>Yang, Shan-Han ; Lin, Yi-Shiuan ; Lee, Chien-Nan ; Cheng, Ya-Jung ; Chen, Ying-Hsi ; Chiu, Hsin-Chan ; Wu, Chun-Yu</creator><contributor>Choi, Geun Joo</contributor><creatorcontrib>Yang, Shan-Han ; Lin, Yi-Shiuan ; Lee, Chien-Nan ; Cheng, Ya-Jung ; Chen, Ying-Hsi ; Chiu, Hsin-Chan ; Wu, Chun-Yu ; Choi, Geun Joo</creatorcontrib><description>Background. Although fixed-volume conventional fluid preloading protocol fails to attenuate postspinal hypotension during cesarean delivery, the effect of goal-directed fluid therapy (GDFT) remains less explored. Continuous noninvasive finger cuff arterial pressure monitoring using devices such as the ClearSight System can provide the noninvasive stroke volume value, enabling clinicians to perform GDFT before spinal anesthesia; however, the efficacy of GDFT requires further elucidation. Method. In total, 71 consecutive full-term pregnant women were randomly divided into a control group (n=34) and a GDFT group (n=37). Before spinal anesthesia, the control group received a fixed dose (1000 mL) of crystalloid fluid, but the GDFT group received repeated 3 mL/kg body weight of crystalloid fluid challenges within 3 minutes with a 1-minute interval between each fluid challenge based on the stroke volume incremental changes obtained using the ClearSight System (targeting a stroke volume increase of ≥5% after a fluid challenge). The primary outcome was the incidence of postspinal hypotension. The secondary outcomes were total fluid volume, vasopressor dosage, hemodynamic parameter changes, maternal adverse effects, and neonatal profiles. Result. Women in the GDFT group received more fluid than did those in the control group (1132±108 vs. 1247±202 mL; p=0.0044), but the incidence of postspinal hypotension (79.4% vs. 73.0%,; p=0.5864) and norepinephrine dose (12.5±10.6 vs. 15.1±12.8 mcg, respectively; p=0.3512) was comparable between the two groups. Fewer women in the GDFT group experienced nausea (61.76% vs. 35.14%; p=0.0332). Neonatal outcomes (Apgar score and umbilical blood analysis) were comparable and typical in both groups. Conclusion. ClearSight-guided GDFT did not ameliorate postspinal hypotension but may reduce nausea. This trial is registered with NCT03013140.</description><identifier>ISSN: 2314-6133</identifier><identifier>EISSN: 2314-6141</identifier><identifier>DOI: 10.1155/2021/6685584</identifier><identifier>PMID: 33855080</identifier><language>eng</language><publisher>United States: Hindawi</publisher><subject>Adult ; Anesthesia ; Apgar score ; Arterial Pressure - physiology ; Blood pressure ; Blood Pressure Determination - instrumentation ; Body weight ; Cardiac arrhythmia ; Cesarean Section ; Dosage ; Epidural ; Fingers - physiology ; Fluid Therapy ; Goals ; Heart rate ; Hemodynamics ; Humans ; Hypotension ; Infant, Newborn ; Intraoperative Care ; Methods ; Nausea ; Neonates ; Norepinephrine ; Optimization ; Patient outcomes ; Patients ; Pregnancy ; Stroke ; Stroke volume ; Surgery ; Women</subject><ispartof>BioMed research international, 2021, Vol.2021 (1), p.6685584-6685584</ispartof><rights>Copyright © 2021 Shan-Han Yang et al.</rights><rights>COPYRIGHT 2021 John Wiley & Sons, Inc.</rights><rights>Copyright © 2021 Shan-Han Yang et al. This is an open access article distributed under the Creative Commons Attribution License (the “License”), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Notwithstanding the ProQuest Terms and Conditions, you may use this content in accordance with the terms of the License. https://creativecommons.org/licenses/by/4.0</rights><rights>Copyright © 2021 Shan-Han Yang et al. 2021</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c476t-b4b536f8bd6535d1a2a2b3d63f4f26e705844bc4fb4833f62d39e74b20649be13</citedby><cites>FETCH-LOGICAL-c476t-b4b536f8bd6535d1a2a2b3d63f4f26e705844bc4fb4833f62d39e74b20649be13</cites><orcidid>0000-0002-9544-8654 ; 0000-0001-9492-5802 ; 0000-0001-9150-4690 ; 0000-0002-1725-0407</orcidid></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019625/pdf/$$EPDF$$P50$$Gpubmedcentral$$Hfree_for_read</linktopdf><linktohtml>$$Uhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC8019625/$$EHTML$$P50$$Gpubmedcentral$$Hfree_for_read</linktohtml><link.rule.ids>230,314,723,776,780,881,4010,27900,27901,27902,53766,53768</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/33855080$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><contributor>Choi, Geun Joo</contributor><creatorcontrib>Yang, Shan-Han</creatorcontrib><creatorcontrib>Lin, Yi-Shiuan</creatorcontrib><creatorcontrib>Lee, Chien-Nan</creatorcontrib><creatorcontrib>Cheng, Ya-Jung</creatorcontrib><creatorcontrib>Chen, Ying-Hsi</creatorcontrib><creatorcontrib>Chiu, Hsin-Chan</creatorcontrib><creatorcontrib>Wu, Chun-Yu</creatorcontrib><title>Implications of Continuous Noninvasive Finger Cuff Arterial Pressure Device Use during Cesarean Delivery for Goal-Directed Fluid Therapy Preload Optimization: A Randomized Controlled Trial</title><title>BioMed research international</title><addtitle>Biomed Res Int</addtitle><description>Background. Although fixed-volume conventional fluid preloading protocol fails to attenuate postspinal hypotension during cesarean delivery, the effect of goal-directed fluid therapy (GDFT) remains less explored. Continuous noninvasive finger cuff arterial pressure monitoring using devices such as the ClearSight System can provide the noninvasive stroke volume value, enabling clinicians to perform GDFT before spinal anesthesia; however, the efficacy of GDFT requires further elucidation. Method. In total, 71 consecutive full-term pregnant women were randomly divided into a control group (n=34) and a GDFT group (n=37). Before spinal anesthesia, the control group received a fixed dose (1000 mL) of crystalloid fluid, but the GDFT group received repeated 3 mL/kg body weight of crystalloid fluid challenges within 3 minutes with a 1-minute interval between each fluid challenge based on the stroke volume incremental changes obtained using the ClearSight System (targeting a stroke volume increase of ≥5% after a fluid challenge). The primary outcome was the incidence of postspinal hypotension. The secondary outcomes were total fluid volume, vasopressor dosage, hemodynamic parameter changes, maternal adverse effects, and neonatal profiles. Result. Women in the GDFT group received more fluid than did those in the control group (1132±108 vs. 1247±202 mL; p=0.0044), but the incidence of postspinal hypotension (79.4% vs. 73.0%,; p=0.5864) and norepinephrine dose (12.5±10.6 vs. 15.1±12.8 mcg, respectively; p=0.3512) was comparable between the two groups. Fewer women in the GDFT group experienced nausea (61.76% vs. 35.14%; p=0.0332). Neonatal outcomes (Apgar score and umbilical blood analysis) were comparable and typical in both groups. Conclusion. ClearSight-guided GDFT did not ameliorate postspinal hypotension but may reduce nausea. This trial is registered with NCT03013140.</description><subject>Adult</subject><subject>Anesthesia</subject><subject>Apgar score</subject><subject>Arterial Pressure - physiology</subject><subject>Blood pressure</subject><subject>Blood Pressure Determination - instrumentation</subject><subject>Body weight</subject><subject>Cardiac arrhythmia</subject><subject>Cesarean Section</subject><subject>Dosage</subject><subject>Epidural</subject><subject>Fingers - physiology</subject><subject>Fluid Therapy</subject><subject>Goals</subject><subject>Heart rate</subject><subject>Hemodynamics</subject><subject>Humans</subject><subject>Hypotension</subject><subject>Infant, Newborn</subject><subject>Intraoperative Care</subject><subject>Methods</subject><subject>Nausea</subject><subject>Neonates</subject><subject>Norepinephrine</subject><subject>Optimization</subject><subject>Patient outcomes</subject><subject>Patients</subject><subject>Pregnancy</subject><subject>Stroke</subject><subject>Stroke volume</subject><subject>Surgery</subject><subject>Women</subject><issn>2314-6133</issn><issn>2314-6141</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2021</creationdate><recordtype>article</recordtype><sourceid>RHX</sourceid><sourceid>EIF</sourceid><sourceid>BENPR</sourceid><recordid>eNp9kk1vEzEQhlcIRKvSG2dkiQsShPprvbsckKKUlEoVRSg9W971OHHl2Km9GxR-Gz8OLwnh44BlySPPM69fj6YonhP8lpCyvKCYkgsh6rKs-aPilDLCJ4Jw8vgYM3ZSnKd0j_OqicCNeFqcMJYrcI1Pi-_X642znept8AkFg2bB99YPYUjoU_DWb1WyW0Bz65cQ0WwwBk1jD9Eqhz5HSGmIgC5haztAdwmQHmJG0QySiqB8TrlcH3fIhIiugnKTSxuh60GjuRusRosVRLXZjWIuKI1uN71d228_Hb1DU_RFeR3yRS4YvcXgXA4Xo4FnxROjXILzw3lW3M0_LGYfJze3V9ez6c2k45XoJy1vSyZM3WpRslITRRVtmRbMcEMFVDg3j7cdNy2vGTOCatZAxVuKBW9aIOyseL_X3QztGnQH2YZychPtWsWdDMrKvzPeruQybGWNSSNomQVeHQRieBgg9XJtUwfOKQ-505KWhFHOK1Zl9OU_6H0Yos_fyxSuqSgpqX9TS-VAWm9CfrcbReVUNKLhJO9MvdlTXQwpRTBHywTLcX7kOD_yMD8Zf_HnN4_wr2nJwOs9sLJeq6_2_3I_ADj6z1c</recordid><startdate>2021</startdate><enddate>2021</enddate><creator>Yang, Shan-Han</creator><creator>Lin, Yi-Shiuan</creator><creator>Lee, Chien-Nan</creator><creator>Cheng, Ya-Jung</creator><creator>Chen, Ying-Hsi</creator><creator>Chiu, Hsin-Chan</creator><creator>Wu, Chun-Yu</creator><general>Hindawi</general><general>John Wiley & Sons, Inc</general><general>Hindawi Limited</general><scope>RHU</scope><scope>RHW</scope><scope>RHX</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>3V.</scope><scope>7QL</scope><scope>7QO</scope><scope>7T7</scope><scope>7TK</scope><scope>7U7</scope><scope>7U9</scope><scope>7X7</scope><scope>7XB</scope><scope>88E</scope><scope>8FD</scope><scope>8FE</scope><scope>8FG</scope><scope>8FH</scope><scope>8FI</scope><scope>8FJ</scope><scope>8FK</scope><scope>ABUWG</scope><scope>AFKRA</scope><scope>ARAPS</scope><scope>AZQEC</scope><scope>BBNVY</scope><scope>BENPR</scope><scope>BGLVJ</scope><scope>BHPHI</scope><scope>C1K</scope><scope>CCPQU</scope><scope>CWDGH</scope><scope>DWQXO</scope><scope>FR3</scope><scope>FYUFA</scope><scope>GHDGH</scope><scope>GNUQQ</scope><scope>H94</scope><scope>HCIFZ</scope><scope>K9.</scope><scope>LK8</scope><scope>M0S</scope><scope>M1P</scope><scope>M7N</scope><scope>M7P</scope><scope>P5Z</scope><scope>P62</scope><scope>P64</scope><scope>PIMPY</scope><scope>PQEST</scope><scope>PQQKQ</scope><scope>PQUKI</scope><scope>7X8</scope><scope>5PM</scope><orcidid>https://orcid.org/0000-0002-9544-8654</orcidid><orcidid>https://orcid.org/0000-0001-9492-5802</orcidid><orcidid>https://orcid.org/0000-0001-9150-4690</orcidid><orcidid>https://orcid.org/0000-0002-1725-0407</orcidid></search><sort><creationdate>2021</creationdate><title>Implications of Continuous Noninvasive Finger Cuff Arterial Pressure Device Use during Cesarean Delivery for Goal-Directed Fluid Therapy Preload Optimization: A Randomized Controlled Trial</title><author>Yang, Shan-Han ; Lin, Yi-Shiuan ; Lee, Chien-Nan ; Cheng, Ya-Jung ; Chen, Ying-Hsi ; Chiu, Hsin-Chan ; Wu, Chun-Yu</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c476t-b4b536f8bd6535d1a2a2b3d63f4f26e705844bc4fb4833f62d39e74b20649be13</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2021</creationdate><topic>Adult</topic><topic>Anesthesia</topic><topic>Apgar score</topic><topic>Arterial Pressure - physiology</topic><topic>Blood pressure</topic><topic>Blood Pressure Determination - instrumentation</topic><topic>Body weight</topic><topic>Cardiac arrhythmia</topic><topic>Cesarean Section</topic><topic>Dosage</topic><topic>Epidural</topic><topic>Fingers - physiology</topic><topic>Fluid Therapy</topic><topic>Goals</topic><topic>Heart rate</topic><topic>Hemodynamics</topic><topic>Humans</topic><topic>Hypotension</topic><topic>Infant, Newborn</topic><topic>Intraoperative Care</topic><topic>Methods</topic><topic>Nausea</topic><topic>Neonates</topic><topic>Norepinephrine</topic><topic>Optimization</topic><topic>Patient outcomes</topic><topic>Patients</topic><topic>Pregnancy</topic><topic>Stroke</topic><topic>Stroke volume</topic><topic>Surgery</topic><topic>Women</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Yang, Shan-Han</creatorcontrib><creatorcontrib>Lin, Yi-Shiuan</creatorcontrib><creatorcontrib>Lee, Chien-Nan</creatorcontrib><creatorcontrib>Cheng, Ya-Jung</creatorcontrib><creatorcontrib>Chen, Ying-Hsi</creatorcontrib><creatorcontrib>Chiu, Hsin-Chan</creatorcontrib><creatorcontrib>Wu, Chun-Yu</creatorcontrib><collection>Hindawi Publishing Complete</collection><collection>Hindawi Publishing Subscription Journals</collection><collection>Hindawi Publishing Open Access</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>ProQuest Central (Corporate)</collection><collection>Bacteriology Abstracts (Microbiology B)</collection><collection>Biotechnology Research Abstracts</collection><collection>Industrial and Applied Microbiology Abstracts (Microbiology A)</collection><collection>Neurosciences Abstracts</collection><collection>Toxicology Abstracts</collection><collection>Virology and AIDS Abstracts</collection><collection>Health & Medical Collection</collection><collection>ProQuest Central (purchase pre-March 2016)</collection><collection>Medical Database (Alumni Edition)</collection><collection>Technology Research Database</collection><collection>ProQuest SciTech Collection</collection><collection>ProQuest Technology Collection</collection><collection>ProQuest Natural Science Collection</collection><collection>Hospital Premium Collection</collection><collection>Hospital Premium Collection (Alumni Edition)</collection><collection>ProQuest Central (Alumni) (purchase pre-March 2016)</collection><collection>ProQuest Central (Alumni Edition)</collection><collection>ProQuest Central UK/Ireland</collection><collection>Advanced Technologies & Aerospace Collection</collection><collection>ProQuest Central Essentials</collection><collection>Biological Science Collection</collection><collection>ProQuest Central</collection><collection>Technology Collection</collection><collection>Natural Science Collection</collection><collection>Environmental Sciences and Pollution Management</collection><collection>ProQuest One Community College</collection><collection>Middle East & Africa Database</collection><collection>ProQuest Central Korea</collection><collection>Engineering Research Database</collection><collection>Health Research Premium Collection</collection><collection>Health Research Premium Collection (Alumni)</collection><collection>ProQuest Central Student</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>SciTech Premium Collection</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>ProQuest Biological Science Collection</collection><collection>Health & Medical Collection (Alumni Edition)</collection><collection>Medical Database</collection><collection>Algology Mycology and Protozoology Abstracts (Microbiology C)</collection><collection>Biological Science Database</collection><collection>Advanced Technologies & Aerospace Database</collection><collection>ProQuest Advanced Technologies & Aerospace Collection</collection><collection>Biotechnology and BioEngineering Abstracts</collection><collection>Publicly Available Content Database</collection><collection>ProQuest One Academic Eastern Edition (DO NOT USE)</collection><collection>ProQuest One Academic</collection><collection>ProQuest One Academic UKI Edition</collection><collection>MEDLINE - Academic</collection><collection>PubMed Central (Full Participant titles)</collection><jtitle>BioMed research international</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Yang, Shan-Han</au><au>Lin, Yi-Shiuan</au><au>Lee, Chien-Nan</au><au>Cheng, Ya-Jung</au><au>Chen, Ying-Hsi</au><au>Chiu, Hsin-Chan</au><au>Wu, Chun-Yu</au><au>Choi, Geun Joo</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Implications of Continuous Noninvasive Finger Cuff Arterial Pressure Device Use during Cesarean Delivery for Goal-Directed Fluid Therapy Preload Optimization: A Randomized Controlled Trial</atitle><jtitle>BioMed research international</jtitle><addtitle>Biomed Res Int</addtitle><date>2021</date><risdate>2021</risdate><volume>2021</volume><issue>1</issue><spage>6685584</spage><epage>6685584</epage><pages>6685584-6685584</pages><issn>2314-6133</issn><eissn>2314-6141</eissn><abstract>Background. Although fixed-volume conventional fluid preloading protocol fails to attenuate postspinal hypotension during cesarean delivery, the effect of goal-directed fluid therapy (GDFT) remains less explored. Continuous noninvasive finger cuff arterial pressure monitoring using devices such as the ClearSight System can provide the noninvasive stroke volume value, enabling clinicians to perform GDFT before spinal anesthesia; however, the efficacy of GDFT requires further elucidation. Method. In total, 71 consecutive full-term pregnant women were randomly divided into a control group (n=34) and a GDFT group (n=37). Before spinal anesthesia, the control group received a fixed dose (1000 mL) of crystalloid fluid, but the GDFT group received repeated 3 mL/kg body weight of crystalloid fluid challenges within 3 minutes with a 1-minute interval between each fluid challenge based on the stroke volume incremental changes obtained using the ClearSight System (targeting a stroke volume increase of ≥5% after a fluid challenge). The primary outcome was the incidence of postspinal hypotension. The secondary outcomes were total fluid volume, vasopressor dosage, hemodynamic parameter changes, maternal adverse effects, and neonatal profiles. Result. Women in the GDFT group received more fluid than did those in the control group (1132±108 vs. 1247±202 mL; p=0.0044), but the incidence of postspinal hypotension (79.4% vs. 73.0%,; p=0.5864) and norepinephrine dose (12.5±10.6 vs. 15.1±12.8 mcg, respectively; p=0.3512) was comparable between the two groups. Fewer women in the GDFT group experienced nausea (61.76% vs. 35.14%; p=0.0332). Neonatal outcomes (Apgar score and umbilical blood analysis) were comparable and typical in both groups. Conclusion. ClearSight-guided GDFT did not ameliorate postspinal hypotension but may reduce nausea. This trial is registered with NCT03013140.</abstract><cop>United States</cop><pub>Hindawi</pub><pmid>33855080</pmid><doi>10.1155/2021/6685584</doi><tpages>1</tpages><orcidid>https://orcid.org/0000-0002-9544-8654</orcidid><orcidid>https://orcid.org/0000-0001-9492-5802</orcidid><orcidid>https://orcid.org/0000-0001-9150-4690</orcidid><orcidid>https://orcid.org/0000-0002-1725-0407</orcidid><oa>free_for_read</oa></addata></record> |
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| subjects | Adult Anesthesia Apgar score Arterial Pressure - physiology Blood pressure Blood Pressure Determination - instrumentation Body weight Cardiac arrhythmia Cesarean Section Dosage Epidural Fingers - physiology Fluid Therapy Goals Heart rate Hemodynamics Humans Hypotension Infant, Newborn Intraoperative Care Methods Nausea Neonates Norepinephrine Optimization Patient outcomes Patients Pregnancy Stroke Stroke volume Surgery Women |
| title | Implications of Continuous Noninvasive Finger Cuff Arterial Pressure Device Use during Cesarean Delivery for Goal-Directed Fluid Therapy Preload Optimization: A Randomized Controlled Trial |
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