title: Use of a minimally invasive uncalibrated cardiac output monitor in patients undergoing cesarean section under spinal anesthesia: report of four cases.
abstract: OBJECTIVE
  Hemodynamic changes are observed during cesarean section under spinal anesthesia. Non-invasive blood pressure (BP) and heart rate (HR) measurements are performed to diagnose these changes, but they are delayed and inaccurate. Other monitors such as filling pressure and cardiac output (CO) catheters with external calibration are very invasive or inaccurate. The objective of the present study was to report the cardiac output measurements obtained with a minimally invasive uncalibrated monitor (LiDCO rapid) in patients undergoing cesarean section under spinal anesthesia.
  
  
  METHODS
  After approval by the Ethics Commission, four patients agreed to participate in this study. They underwent cesarean section under spinal anesthesia while at the same time being connected to the LiDCO rapid by a radial artery line. Cardiac output, HR, and BP were recorded at baseline, after spinal anesthesia, after fetal and placental extraction, and after the infusion of oxytocin and metaraminol. We observed a fall in BP with an increase of HR and CO after spinal anesthesia and oxytocin infusion; and an increase in BP with a fall in HR and CO after bolus of the vasopressor.
  
  
  CONCLUSIONS
  Although this monitor had not been calibrated, it showed a tendency for consistent hemodynamic data in obstetric patients and it may be used as a therapeutic guide or experimental tool.
authors.affiliation: Divisão de Anestesia, Hospital das Clínicas da Faculdade de Medicina da USP, São Paulo, Brazil. fernandobli@uol.com.br
authors.forename: Fernando
authors.initials: F
authors.lastname: Bliacheriene
authors.forename: Maria José Carvalho
authors.initials: MJ
authors.lastname: Carmona
authors.forename: Cristina de Freitas Madeira
authors.initials: Cde F
authors.lastname: Barretti
authors.forename: Cristiane Maria Federicci
authors.initials: CM
authors.lastname: Haddad
authors.forename: Elaine Soubhi
authors.initials: ES
authors.lastname: Mouchalwat
authors.forename: Maria Rita de Figueiredo Lemos
authors.initials: MR
authors.lastname: Bortolotto
authors.forename: Rossana Pulcineli Vieira
authors.initials: RP
authors.lastname: Francisco
authors.forename: Marcelo
authors.initials: M
authors.lastname: Zugaib
mesh_terms: D000328:Adult; D000773:Anesthesia, Obstetrical; D000775:Anesthesia, Spinal; D002302:Cardiac Output; D002585:Cesarean Section; D005260:Female; D006801:Humans; D016343:Monitoring, Intraoperative / Q000379:methods*; D011247:Pregnancy