当前位置： SCI文献检索 > BRITISH JOURNAL OF ANAESTHESIA期刊下所有文献 > Haemodynamic effects from aortocaval compression at different angles of lateral tilt in non-labouring term pregnant women.

Haemodynamic effects from aortocaval compression at different angles of lateral tilt in non-labouring term pregnant women.

Abstract：

BACKGROUND:Aortocaval compression (ACC) can result in haemodynamic disturbances and uteroplacental hypoperfusion in parturients. Its detection is difficult because in most patients, sympathetic compensation results in no signs or symptoms. However, profound hypotension may develop after sympathectomy during regional anaesthesia. In this prospective observational study, we aimed to detect ACC by analysing haemodynamic changes in term parturients who were positioned sequentially at different angles of lateral tilt. METHODS:We studied haemodynamic changes in 157 non-labouring term parturients who were positioned in random order at 0°, 7.5°, 15°, and full left lateral tilt. Cardiac output (CO), stroke volume, and systemic vascular resistance were derived using suprasternal Doppler. Non-invasive arterial pressure (AP) measured in the upper and lower limbs was analysed to detect aortic compression. RESULTS:CO was on average 5% higher when patients were tilted at ≥15° compared with <15°. In a subgroup of patients (n=11), CO decreased by more than 20%, without changes in systolic AP, when they were tilted to <15° which was considered attributable to severe inferior vena caval compression. Only one patient in the supine position had aortic compression with the systolic AP in the upper limb 25 mm Hg higher than the lower limb. CONCLUSIONS:Patients with ACC can be identified by the CO changes from serial measurements between supine, 15°, or full lateral tilt. Our findings suggest that in non-labouring parturients, ACC is asymptomatic and can be effectively minimized by the use of a left lateral tilt of 15° or greater.

journal_name

Br J Anaesth

journal_title

British journal of anaesthesia

authors

Lee SW,Khaw KS,Ngan Kee WD,Leung TY,Critchley LA

doi

10.1093/bja/aes349

subject

Has Abstract

pub_date

2012-12-01 00:00:00

pages

950-6

issue

6

eissn

0007-0912

issn

1471-6771

pii

S0007-0912(17)31602-1

journal_volume

109

pub_type

杂志文章,随机对照试验

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