Impact of non-invasive continuous blood pressure monitoring on maternal hypotension during cesarean delivery: a randomized-controlled study

Juri, Takashi; Suehiro, Koichi; Kimura, Aya; Mukai, Akira; Tanaka, Katsuaki; Yamada, Tokuhiro; Mori, Takashi; Nishikawa, Kiyonobu

doi:10.1007/s00540-018-2560-2

Cited by 23 publications

(38 citation statements)

References 29 publications

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“…These procedures are performed throughout the whole cardiac cycle, allowing continuous blood pressure monitoring [10]. The ClearSight system has been evaluated in various clinical situations [11][12][13][14], and its use is known to be associated with a lower rate of hypotensive events [14][15][16].…”

Section: Introductionmentioning

confidence: 99%

Continuous Non-Invasive Arterial Pressure Monitoring (ClearSight System) and Ankle Blood Pressure Measurements as Alternatives to Conventional Arm Blood Pressure

Lee

Chung

Bae

et al. 2020

JCM

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Measuring blood pressure (BP) via a pneumatic cuff placed around the arm has long been the standard method. However, in clinical situations where BP monitoring at the arm is difficult, the ankle is frequently used instead. We compared continuous non-invasive blood pressure (CNBP) measurements obtained at the finger, ankle BP and arm BP in patients undergoing breast cancer surgery. Arm BP, ankle BP (both obtained with a conventional pneumatic cuff) and CNBP measurements were obtained every 2.5 min during surgery. Correlation and Bland–Altman analyses were performed and differences among measurements were analyzed using a linear mixed model. A total of 245 sets of BP measurements were obtained from 10 patients. All systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) measurements of ankle BP and CNBP were positively correlated with the arm BP measurements (Spearman rho 0.688–0.836, p < 0.001 for each correlation). The difference between CNBP and arm SBP was significantly smaller (least squares mean (95% confidence interval): −6.03 (−11.40, −0.67)) compared to that between ankle and arm SBP (least squares mean (95% CI): −15.32 (−20.69, −9.96), p = 0.019). However, this significant difference was not observed in DBP and MBP (−1.23 vs. 1.75, p = 0.190 and −3.85 vs. −2.63, p = 0.604, respectively). Ankle SBP measurements showed larger differences from arm SBP measurements than did CNBP SBP measurements in patients undergoing breast cancer surgery. CNBP could serve as a useful alternative to ankle BP when standard arm BP measurements cannot be obtained.

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Section: Introductionmentioning

confidence: 99%

Continuous Non-Invasive Arterial Pressure Monitoring (ClearSight System) and Ankle Blood Pressure Measurements as Alternatives to Conventional Arm Blood Pressure

Lee

Chung

Bae

et al. 2020

JCM

View full text Add to dashboard Cite

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“…In recent years, studies have reported the use of the ClearSight™ (previously called Nexfin™) continuous non-invasive hemodynamic monitoring system during cesarean section [13,18]. These reports demonstrated that use of the ClearSight™ system helped minimize the incidence of intraoperative maternal hypotension.…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management for cesarean section in a patient receiving transplacental treatment of fetal tachyarrhythmia: a case report

et al. 2019

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Background: Although rare, long-lasting fetal tachyarrhythmia often leads to fetal heart failure and hydrops. Some mothers receive transplacental treatment of fetal tachyarrhythmia (TTFT), which can potentially worsen maternal hypotension and bradycardia. Moreover, the use of rescue cardiovascular agents intraoperatively can worsen fetal tachycardia. However, reports of the anesthetic management of patients receiving TTFT are rare. Case presentation: A 31-year-old woman who was receiving digoxin and sotalol for TTFT underwent planned elective cesarean section. The fetus had hypoplastic left heart syndrome, hydrops, and tachycardia. We used combined spinal-epidural anesthesia with a reduced dose of local anesthetic. We also employed a non-invasive continuous hemodynamic monitoring system. The mother's systolic blood pressure remained at ≥ 90% of the baseline value; intraoperative administration of rescue cardiovascular agents was not required. Conclusions: We successfully anesthetized a woman for cesarean section, who was receiving TTFT for fetal tachyarrhythmia, using combined spinal-epidural anesthesia and non-invasive continuous hemodynamic monitoring.

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“…The ClearSight™ system is a hemodynamic monitoring system that allows for real-time non-invasive BP measurements. Juri et al reported the efficacy of the Clear-Sight™ system during cesarean section with accurate BP management [8]. Sumiyoshi et al also reported that there is a significant relationship between mean arterial pressure and mean arterial pressure of the ClearSight™ system in patients with abdominal aortic aneurysm surgery [9].…”

Section: Discussionmentioning

confidence: 99%

Anesthetic management of modified electroconvulsive therapy for a patient with coronary aneurysms: a case report

et al. 2019

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Background: Modified electroconvulsive therapy (m-ECT) is utilized worldwide as an effective treatment for drugresistant psychiatric disorders. However, during m-ECT, treatment of hypotension and hypertension in response to rapid hemodynamic changes is required. We used noninvasive continuous blood pressure monitoring system for continuous hemodynamic measurement during m-ECT. Case presentation: The patient was a 77-year-old man with depression complicated by coronary artery aneurysms (CAAs). We managed general anesthesia during m-ECT by using the ClearSight™ system (Edwards Lifesciences Corp, Irvine, CA, USA) for hemodynamic measurement. As a result, we performed a total of 10 m-ECTs. No rupture of CAAs or myocardial ischemia occurred and depressive symptoms improved. Conclusion: We successfully managed the anesthesia in m-ECT for a depressed patient with CAAs without complications by using the ClearSight™ system, which was used for the effective management of circulatory fluctuations.

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Impact of non-invasive continuous blood pressure monitoring on maternal hypotension during cesarean delivery: a randomized-controlled study

Cited by 23 publications

References 29 publications

Continuous Non-Invasive Arterial Pressure Monitoring (ClearSight System) and Ankle Blood Pressure Measurements as Alternatives to Conventional Arm Blood Pressure

Continuous Non-Invasive Arterial Pressure Monitoring (ClearSight System) and Ankle Blood Pressure Measurements as Alternatives to Conventional Arm Blood Pressure

Anesthetic management for cesarean section in a patient receiving transplacental treatment of fetal tachyarrhythmia: a case report

Anesthetic management of modified electroconvulsive therapy for a patient with coronary aneurysms: a case report

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