Wei Xiao1, Qingfang Duan1, Lei Zhao1, Xinzuo Chi2, Fengying Wang2, Daqing Ma3, Tianlong Wang1. 1. Department of Anesthesiology, Capital Medical University, Beijing, China. 2. Department of Obstetrics and Gynecology, Xuan Wu Hospital, Capital Medical University, Beijing, China. 3. Anaesthetics, Pain Medicine and Intensive Care, Department of Surgery and Cancer, Faculty of Medicine, Imperial College London, Chelsea and Westminster Hospital, London, UK.
Abstract
AIM: To investigate whether goal-directed fluid therapy (GDFT) with the LiDCOrapid system can reduce the incidence of maternal hypotension and improve neonatal outcome. METHODS:One hundred healthy term parturient women scheduled for elective cesarean section were recruited. After loading with 10 mL/kg Lactated Ringer's solution, parturient women were randomized to the GDFT and control group. In the GDFT group, individualized fluid therapy was implemented to optimize stroke volume, guided by the LiDCOrapid system. The control group received routine fluid therapy. Primary endpoints included onset of maternal hypotension, and vasopressor doses prior to delivery. The secondary endpoints included umbilical blood gas abnormalities and neonatal adverse events. RESULTS:Incidence of hypotension and mean phenylephrine dose administered prior to delivery were significantly higher in the control group than in the GDFT group (P < 0.01). There was no difference in Apgar score between the two groups. In the control group, mean umbilical artery and vein blood pH were significantly lower, corresponding to significantly higher incidences of neonatal hypercapnia and hypoxemia, compared with the GDFT group (P < 0.05). CONCLUSIONS:LiDCOrapid -guided GDFT may provide benefit to healthy parturient women and their newborns.
RCT Entities:
AIM: To investigate whether goal-directed fluid therapy (GDFT) with the LiDCOrapid system can reduce the incidence of maternal hypotension and improve neonatal outcome. METHODS: One hundred healthy term parturient women scheduled for elective cesarean section were recruited. After loading with 10 mL/kg Lactated Ringer's solution, parturient women were randomized to the GDFT and control group. In the GDFT group, individualized fluid therapy was implemented to optimize stroke volume, guided by the LiDCOrapid system. The control group received routine fluid therapy. Primary endpoints included onset of maternal hypotension, and vasopressor doses prior to delivery. The secondary endpoints included umbilical blood gas abnormalities and neonatal adverse events. RESULTS: Incidence of hypotension and mean phenylephrine dose administered prior to delivery were significantly higher in the control group than in the GDFT group (P < 0.01). There was no difference in Apgar score between the two groups. In the control group, mean umbilical artery and vein blood pH were significantly lower, corresponding to significantly higher incidences of neonatal hypercapnia and hypoxemia, compared with the GDFT group (P < 0.05). CONCLUSIONS:LiDCOrapid -guided GDFT may provide benefit to healthy parturient women and their newborns.
Authors: Cheryl Chooi; Julia J Cox; Richard S Lumb; Philippa Middleton; Mark Chemali; Richard S Emmett; Scott W Simmons; Allan M Cyna Journal: Cochrane Database Syst Rev Date: 2020-07-01