Pulse Contour Analysis for Prediction of Fluid Responsiveness in Preeclamptic Patients: A Case Series

Luciano Frassanito*¹, Massimo Antonelli¹, Antonio Messina², Davide Colombo² and Gaetano Draisci¹

Received: June 01, 2018;   Published: June 12, 2018

DOI: 10.26717/BJSTR.2018.05.001210

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Abstract

Preeclampsia (PE) is a pregnancy-specific syndrome characterized by maternal cardiac output (CO) alterations and relative hypovolemia. In patients with PE is mandatory to predict Fluid Responsiveness (FR), above all if caesarean section (CS) under spinal anesthesia is required. The fluid challenge (FC) is a diagnostic approach to hemodynamic management which aims at identifying the patients who respond to fluid administration with an increase in CO. We present a case series to evaluate the effectiveness of a FC in increasing Cardiac Index (CI) in a group of preeclamptic patients using a continuous pulse-contour analysis. We studied the percentage of patients with PE scheduled for caesarean delivery who had a 15% increase of CI after a FC, in comparison with a control group of healthy pregnant patients. At baseline the patients in PE group showed higher Mean Arterial Pressure (MAP) and lower Stroke Volume Index (SVI). Fifteen patients were non responders (69% of the patients in PE group and 46% of the patients in control). We suggest that the hemodynamic measurement of CI is useful to guide fluid therapy in pregnant woman with PE, and caution should be taken during fluid administration in all healthy pregnant woman at term.

Abbreviations:PE: Preeclampsia; CO: Cardiac Output; CS: Caesarean Section; FC: Fluid Challenge; CI: Cardiac Index; MAP: Mean Arterial Pressure; SVI: Stroke Volume Index; FR: Fluid Responsiveness; SV: Stroke Volume

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