Anesthesiology Research and Practice / 2020 / Article / Tab 1

Research Article

Minimally Invasive Hemodynamic Assessment during Obstetric Hysterectomy for Invasive Placentation with Epidural Anesthesia

Table 1

Goal-directed therapy.

TargetsInterventions

Hemodynamic
 Cardiac index1At least 2.5 L/min/m2Inotropes|Fluids
 Systemic vascular resistance index21250–2500 dynes·sec·cm5/m2Vasopressor|Fluids
 Central venous pressure36–12 mmHgFluids
 Mean arterial pressure265–90 mmHgVasopressor|Fluids

Thromboelastography
 R. Reaction time44–8 minFFP 10 ml/kg
 MA. Maximum amplitude562–84 mmCryoprecipitate 2 ml/Kg and platelet apheresis

Blood Test
 Hemoglobin570–90 gr/LPacked red blood cells
 Platelets5<50 000 c/µLPlatelet apheresis
 Fibrinogen6<200 mg/dLCryoprecipitate 2 ml/Kg
 Prothrombin time5<16FFP 10 ml/kg
 International normalized ratio5<1.5FFP 10 ml/kg

(1) C. Salzwedel, “Perioperative goal-directed hemodynamic therapy based on radial arterial pulse pressure variation and continuous cardiac index trending reduces postoperative complications after major abdominal surgery: A multicenter, prospective, randomized study,” Crit. Care, vol. 17, 2013. (2) J. G. Ouzounian, D. I. Masaki, T. K. Abboud, and J. S. Greenspoon, “Systemic vascular resistance index determined by thoracic electrical bioimpedance predicts the risk for maternal hypotension during regional anesthesia for cesarean delivery,” Am. J. Obstet. Gynecol., vol. 174, pp. 1019–1025, 1996. (3) A. Donati, “Goal-directed intraoperative therapy reduces morbidity and length of hospital stay in high-risk surgical patients,” Chest, vol. 132, pp. 1817–1824, Dec. 2007. (4) K. M. Antony, “Establishing thromboelastography with platelet-function analyzer reference ranges and other measures in healthy term pregnant women,” Am. J. Perinatol., vol. 32, pp. 545–553, 2015. (5) D. R. Spahn, “Management of bleeding and coagulopathy following major trauma: an updated European guideline,” Crit. Care, vol. 17, pp. 1–45, 2013. (6) A. J. Butwick and L. T. Goodnough, “Transfusion and coagulation management in major obstetric hemorrhage,” Curr. Opin. Anaesthesiol., vol. 28, pp. 275–284, 2015.

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