Perioperative hemodynamics obtained by pulse contour analysis facilitated the management of a patient with chronic hypertension, renal insufficiency, and superimposed preeclampsia during cesarean delivery.
A 23 year-old woman with chronic hypertension, focal segmental glomerular sclerosis with chronic renal insufficiency, and superimposed severe preeclampsia, required cesarean delivery. The patient's course was also complicated by severe hyperkalemia and hypermagnesemia. "PulseCO" pulse contour analysis of a directly measured radial artery pressure tracing, without lithium calibration, enabled her physicians to follow trends in cardiac output and systemic vascular resistance, facilitating and rationalizing her care. The limitations of pulse contour analysis are discussed.
Archer
Thomas L
TL
Department of Anesthesiology, University of Texas Health Science Center, San Antonio, TX 78229, USA. tarcher@ucsd.edu
Heitmeyer
J D
JD
D002302:Cardiac Output; D002585:Cesarean Section / Q000379:methods*; D002908:Chronic Disease; D005260:Female; D005923:Glomerulosclerosis, Focal Segmental / Q000150:complications; D006439:Hemodynamics; D006801:Humans; D006947:Hyperkalemia / Q000150:complications; D006973:Hypertension / Q000150:complications; D008274:Magnesium / Q000097:blood; D016343:Monitoring, Intraoperative / Q000379:methods*; D011225:Pre-Eclampsia / Q000503:physiopathology*; D011247:Pregnancy; D011248:Pregnancy Complications / Q000503:physiopathology*; D017534:Radial Artery; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012720:Severity of Illness Index; D055815:Young Adult
D008274:Magnesium