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Background: Preeclampsia is a syndrome characterized by hypertension and organ system involvement. Fluid assessment is essential to avoid complications. Point of care ultrasonography (POCUS) is noninvasive tool used in assessment of parturients with preeclampsia. Objective: This study evaluated perioperative ultrasonography for assessment of lung congestion, optic nerve sheath diameter (ONSD), and IVC diameters in parturients with preeclampsia. We hypothesized a difference in pulmonary congestion over time during cesarean delivery. Patients and methods: This was a prospective observational study of one hundred ASA II-III parturients with preeclampsia, singleton pregnancy undergoing elective cesarean delivery under spinal anesthesia. Lung ultrasonography, IVC diameters and ONSD ultrasound performed at baseline, at 1 h and 2 h after spinal anesthesia, Lung ultrasound for quantification of the Echo Comet Score (ECS). The maximum and minimum IVC diameters assessed using the subcostal long-axis view. ONSD measured 3 mm behind the globe. Results: No significant difference in the ECS and ONSD at 1 hour and 2 hours compared with baseline (P=0.46), (P=0.16) respectively. The maximum and minimum IVC diameters were larger at 1 h and 2 h compared with baseline (P<0.0001).There was a positive correlation between the ECS and ONSD at 2 h. (r 2 = 0.689, P<0.001). Conclusion:No significant difference in the ECS and ONSD at 1 hour and 2 hours after spinal anesthesia compared with baseline. Non-invasive POCUS used for fluid assessment in parturients with preeclampsia.

Background: Optimum perioperative fluid therapy is important to improve the outcome of surgical patients, so the assessment of a patient's volume status accurately is an important goal for the anesthesiologist to achieve hemodynamic stability and adequate tissue oxygenation. Objective: This study compared intraoperative goal-directed fluid therapy (GDFT) versus conventional fluid therapy (CVFT) using noninvasive electrical cardiometry with measuring serum lactate, serum creatinine levels, stroke volume optimization, and postoperative complication. Methods: One hundred patients ASA I -II, both sexes, aged 21-65 years scheduled for elective colorectal surgery were randomized into 2 groups (50 subjects each). GDFT group used Stroke volume optimization, and CVFT used the conventional method of fluid administration. Hemodynamic variables, amount of fluid given, serum lactate, serum creatinine, and postoperative complication were noted. Results: Serum lactate levels were insignificant intra& postoperative except at 6 hrs. postoperative was higher in GDFT 1,79±0.21 than CVFT 1.68±0.23with p value=0.02 but still within normal limits. CVFT received significantly more crystalloids 2750(1500-4000) than GDFT 2250 (1000-3350) with p value=0.002, whereas GDFT received more colloids 350(200-1000) than CVFT 250(0-1000) with p value=0.024. Total fluid received were higher in CVFT 3550(2000-5600) than GDFT 2750(1500-5000) with p-value=0.005. Conclusions: GDFT results in a decreased total volume of crystalloids and fluid given to patients. However, both groups didn't alter organ perfusion inspite of serum lactate being higher in GDFT and with no differences in postoperative complications in both groups.

Background: Spinal anesthesia is often associated with significant hypotension due to a sympathetic block and can increase the risk of perioperative cardiac complications. Transthoracic echocardiography (TTE) is widely used throughout medicine as a clinical, diagnostic and research tool. Portability, accuracy, ease of use and a variety of training courses have encouraged its use. Aim: The present study was designed to evaluate the hemodynamic changes of spinal anesthesia by Transthoracic Echocardiography and test its efficacy as a monitoring tool in lower limb surgery. Methods: The study included 50 patients, who were scheduled for lower limb surgery under spinal anesthesia. Two serial TTE studies were performed. One immediately before spinal anesthesia after giving the preload, then at 10 mins after spinal anesthesia. Changes of heart rate (HR), mean arterial blood pressure (MAP), the total doses of ephedrine and atropine, and data regarding highest sensory level and bromage scale were recorded. Results: Echocardiographic monitoring the heart variables have showed marked decrease when MAP was < 70% of basal values. Conclusion: Transthoracic echocardiography has proved its efficacy as a monitoring tool in assessment and guiding the management of hemodynamic changes after spinal anesthesia.

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